Clinica Chimica Acta 280 (1999) 59–71 Biochemical risk factors and patient’s outcome: the case of lipoprotein(a) a b, * Giuseppe Lippi , Giancesare Guidi a ` Istituto di Chimica e Microscopia Clinica dell’ Universita degli Studi di Verona, Ospedale Policlinico, Via delle Menegone 10, 37134 Verona, Italy b Laboratorio di Analisi Chimico Cliniche e Microbiologiche, Istituto di Chimica e Microscopia Clinica ` dell’ Universitia degli Studi di Verona, Centro Ospedaliero Clinicizzato di Valeggio sul Mincio, 37067 Valeggio sul Mincio, Verona, Italy Received 1 April 1998; received in revised form 23 July 1998; accepted 1 August 1998 Abstract Lipoprotein(a) (Lp(a)) is a genetic variant of low density lipoproteins and consists of the covalent association of the unique and enigmatic apolipoprotein(a) to apoliprotein B100. Despite the high degree of homology with low density lipoproteins, Lp(a) displays distinctive physico- chemical properties, function and metabolism. The present article reviews the main biological and clinical evidences about the association between raised concentration of Lp(a) and athero- thrombotic diseases and provides tentative guidelines to improve the clinical usefulness of Lp(a) measurements.  1999 Elsevier Science B.V. All rights reserved. Keywords: Lipoprotein(a); Low density lipoproteins; Athero-thrombotic diseases 1. Introduction Lipoprotein(a) (Lp(a)) is a circulating particle similar in structure, function and metabolism to low density lipoproteins (LDLs). In Lp(a), the highly glycosilated apolipoprotein(a) (apo(a)) is linked to apolipoprotein B100 (apo B100) by a single disulphide bridge [1]. Although apo(a) is mainly synthesised * Corresponding author. Fax: 1 39-45-7950188; e-mail: gguidi@linus.uni.vr.it 0009-8981 / 99 / $ – see front matter  1999 Elsevier Science B.V. All rights reserved. PII: S0009-8981(98)00198-3