For example Kostner et al.162 have estimated that CAD risk is 2.3 times higher in patients with Lp(a) concentrations >500 mg/L, while Riches and Porter have calculated that risk was twice greater for Lp(a) concentrations >200 mg/L.163 In a meta-analysis of 40 prospective studies with 58,000 participants, a two-fold increase in the risk for developing CAD and cerebral vascular accident was found in individuals with smaller apo(a) isoforms, regardless of the Lp(a) concentration and the classical risk factors.135. This evidence concerns the gene APOA1 and coronary artery disorder.