Lipoprotein(A)-Cholesterol and Coronary Heart Disease in the Framingham Heart Study (Lipids and Lipoproteins‪)‬

In 1963, Kare Berg (1) first described lipoprotein(a) [Lp(a)](5) as a lipoprotein antigen that was more prevalent in the plasma of myocardial infarction survivors than in an age-matched control group of Scandinavian men. Apolipoprotein (a) [apo(a)] is known to be a very heterogeneous glycoprotein that shares at least 75% homology with plasminogen, including domains of plasminogen referred to as kringle 4, kringle 5, and the protease domain. There is no unique domain of the apo(a) gene that does not share homology with plasminogen (2). apo(a) is highly glycosylated (3, 4), with numerous Oglycosidic linkages in the regions between the kringle domains (5). At least 34 phenotypes are expressed, ranging from 12 to 50 kringles (6, 7), and there are potentially more phenotypes and genotypes that may exist.