The mismatch between CVRS and presence and extent of CAD is likely explained by the combination of environmental influences [22] and non-traditional risk factors that can influence atherosclerosis development, such as additional lipoproteins not considered in CVRS [such as Lp(a)], genetic loci [31], psychosocial factors [32], and exercise and diet [29]. This evidence concerns the gene LPA and atherosclerosis.