Forty-three Caucasian heart transplantation (HT) patients were evaluated in a late evolutional phase (27 mais ou menos 20 months, median 24 months). They were on a stable immunosuppressive triple drug regime and were compared with 45 controls (NL). Lipoprotein(a) [Lp(a)], apolipoprotein (apo) AI, B (n=27) and total cholesterol (TC) and tryglicerides (TG) (n=43) were determined after a 14 hour fast. None of the patients had uremia or nephrotic syndrome, uncontrolled diabetes mellitus or other situation known to increased Lp(a) levels. They were not under hypolipidemic drugs. According to the results of serial coronary angiography, HT patients were further divided in two groups: GCD (n=9) and NGCD (n=19) respectively with or without graft coronary disease. Apo AI and Lp(a) were higher in HT patients than in NL, 1.7 mais ou menos 0,3 vs. 1.1 mais ou menos 0,4 g/l respectively, p<0,0001, and medians (25-75 percentiles) 26 (13.4-60.4) vs. 15 (2.4-33.4) mg/dl, p=0.026.TC, TG and apo B were similar in both groups. There were no differences on the lipid profile of both GCD and NGCD patients. These results suggest that Lp(a) is increased in HT, contrarily to early reports that this lipoprotein may be reduced in HT