Vascular interactions of lipoprotein (a).

Lipoprotein (a) is a major inherited risk factor for vascular diseases, including coronary atherosclerosis, restenosis, and stroke. The pathologic mechanisms are uncertain, but are likely to involve the unique plasminogen-like component of this lipoprotein, apolipoprotein (a). Studies suggest that apolipoprotein (a) can enhance lipid deposition in vessel walls, interfere with fibrinolysis, modulate smooth muscle cell activity, and induce endothelial dysfunction. This review discusses the key concepts relating to these mechanisms, with emphasis on recent studies.