The present study was designed to confirm the transient increases of plasma Lp(a) levels as an acute-phase reactant and to clarify the significance of these increases with the use of patients with acute myocardial infarction and patients subjected to surgical operations. Although interleukin 6, C-reactive protein and alpha(1) antitrypsin reached the maximal levels 1-2 days, 3 days and 4-5 days, respectively, after the episodes, the peak time of Lp(a) levels was delayed some extent in both patient groups. Studying the transient increases of Lp(a) levels as a function of apo(a) isoforms analyzed by density-gradient ultracentrifugation and SDS-PAGE, the higher-density Lp(a) particles preferentially containing high-molecular-weight apo(a) isoforms increased more than the lower-density Lp(a) particles containing low-molecular-weight apo(a) after the episodes. The immunohistochemical findings suggest that Lp(a) may play an important role as an acute-phase reactant in the repair of tissue injury, especially in the process of angiogenesis.