Table 1.

Comparison of evidence supporting the contention that elevated low-density lipoprotein cholesterol and elevated lipoprotein(a) each cause cardiovascular disease

	Elevated LDL cholesterol	Elevated Lp(a)
Human epidemiology	Direct association in numerous studies	Direct association in numerous studies
Human genetic studies	Direct association in numerous studies, e.g. familial hypercholesterolaemia	Direct association in numerous studies, e.g. for kringle IV type 2 polymorphism
Mechanistic studies	Mechanism clearly demonstrated: LDL accumulate in intima and cause atherosclerosis	Mechanism similar to that for LDL cholesterol and/or prothrombotic/anti-fibrinolytic effects
Animal models	Proatherogenic effect in numerous studies	Proatherogenic effect in numerous studies
Human intervention trials	Statin trials gave final proof of causality	Niacin trials are favourable
Interpretation in 2010	Causality	Probably causal