This meta-analysis of 27 prospective studies with at least one year of follow-up, published before 2000, examines the association between plasma lipoprotein(a) (Lp(a)) and coronary heart disease (CHD). The studies, involving a total of 5436 CHD cases, were conducted in various countries and included both general populations and patients with preexisting disease. The analysis found a significant association between high Lp(a) levels and increased risk of CHD, with a combined risk ratio of 1.6 (95% CI 1.4 to 1.8) for individuals in the top third of baseline Lp(a) measurements compared to those in the bottom third. This risk ratio was similar when restricted to population-based studies (risk ratio 1.7, 95% CI 1.4 to 1.9). The results were consistent across different study characteristics, such as blood storage methods and assay techniques. Lp(a) was weakly correlated with classical vascular risk factors, and adjustment for these factors did not significantly alter the risk ratios. The study concludes that Lp(a) is a significant risk factor for CHD, but further research is needed to determine the causal nature of this association.This meta-analysis of 27 prospective studies with at least one year of follow-up, published before 2000, examines the association between plasma lipoprotein(a) (Lp(a)) and coronary heart disease (CHD). The studies, involving a total of 5436 CHD cases, were conducted in various countries and included both general populations and patients with preexisting disease. The analysis found a significant association between high Lp(a) levels and increased risk of CHD, with a combined risk ratio of 1.6 (95% CI 1.4 to 1.8) for individuals in the top third of baseline Lp(a) measurements compared to those in the bottom third. This risk ratio was similar when restricted to population-based studies (risk ratio 1.7, 95% CI 1.4 to 1.9). The results were consistent across different study characteristics, such as blood storage methods and assay techniques. Lp(a) was weakly correlated with classical vascular risk factors, and adjustment for these factors did not significantly alter the risk ratios. The study concludes that Lp(a) is a significant risk factor for CHD, but further research is needed to determine the causal nature of this association.