Abstract-To investigate a potential role of lipoprotein(a) [Lp(a)] in foam cell formation, we have measured the degradation rates of Lp(a) and LDL in the rabbit aorta in vivo. Lp(a) (or LDL) was labeled with both 131 I-TC and 125 I and injected into 17 rabbits with extensive aortic atherosclerosis and into 16 rabbits without atherosclerosis. As the protein moiety of the doubly labeled lipoproteins is degraded, 131 I-TC is trapped in the cell, whereas 125 I diffuses out of the cell. Twenty-four hours after injection, 12 samples of the aorta and biopsies from 9 other tissues were removed. The degradation rate of Lp(a) (percent of plasma pool per gram tissue per day) was less than that of LDL in the adrenals and in the intestine. In contrast, degradation rates of Lp(a) and LDL were similar in liver, spleen, kidney, heart, lung, skeletal muscle, and adipose tissue. In nonlesioned aortic intima-inner media, the degradation rate of Lp(a) was 39% of that of LDL (t test: P Ͻ.05 in aortic arch and thoracic aorta), whereas the degradation rates of Lp(a) and LDL were similar in atherosclerotic aortic intima-inner media. Lp(a) degradation rates were markedly increased in atherosclerotic compared with nonlesioned aortic intima-inner media: 28.2Ϯ9.2ϫ10 Ϫ7 % and 5.0Ϯ0.6ϫ10 Ϫ7 % of the plasma pool per gram tissue per day in the intima-inner media of the proximal segment of atherosclerotic and nonlesioned aorta, respectively (t test: P Ͻ.01). These results suggest that the metabolism of Lp (a) phospholipids, triglycerides, and apoB. 1 In epidemiological studies, high plasma levels of Lp(a) have been associated with an increased risk of cardiovascular disease. 2 The mechanism by which Lp(a) may promote atherothrombotic disease is unclear, but several possibilities are suggested by the structure of Lp(a). Lp(a) contains apo(a), which is attached to apoB through a disulfide bridge. 3 Apo(a) has a high degree of structural similarity to plasminogen, 4 and Lp(a) has been shown to inhibit plasmin formation in vitro. 5 As a result of this effect, Lp(a) inhibits fibrinolysis 5 and accelerates growth of smooth muscle cells 6 in vitro. Although these effects could promote the development of atherothrombotic disease, the significance needs to be determined in vivo.Because Lp(a) contains cholesterol and cholesterol esters, uptake and degradation of Lp(a) by monocyte-macrophages in the arterial intima could promote foam cell formation, the pathologic hallmark of early atherosclerosis. 7 In vitro evidence suggests that Lp(a) may be taken up and degraded by macrophage-derived foam cells via a cellular receptor distinct from the LDL receptor, scavenger receptors, the LDL receptor-related protein, or plasminogen receptors. 8 -10 Other studies have shown that Lp(a) can be degraded by monocytemacrophages via the LDL receptor and "nonspecific" pathways. [11][12][13][14][15][16] Complex formation by Lp(a) with glycosaminoglycans or modification of Lp(a) with malondialdehyde results in a markedly enhanced uptake and degradation of Lp(a) by monocyte...