Aims: Coronary artery disease (CAD) is an inflammatory disorder. Recently low vitamin D and high lipoprotein 'a' (Lp'a') have been linked in causation of coronary artery disease. This study was conducted to see the the combined effect of these two modifiable risk factors i.e. low vitamin D and high Lp'a' in etiology of CAD. Methods: It was a cross sectional study. Triple vessel disease patients (n=31) admitted for bypass surgery were taken as cases and age and gender matched healthy persons

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... taken as controls (n=30). Serum vitamin D estimation was done by competitive ELISA method. Serum Lp'a' estimation was done by immunoturbidimetric assay. Results: when subjects were compared for dual risk factor (Vitamin D deficiency and Hyperlipoproteinemia'a'), it was observed that the odds of having disease were very high (OR=30.00; p=0.0004) than the single risk factor (OR for Hypovitaminosis D = 3.33; p=0.03 and OR for Hyperlipoproteinemia 'a' = 5.00; p=0.004). The Pearson's correlation coefficient for the relationship between serum Vitamin D and Lipoprotein 'a' shows no correlation (r = ̶ 0.1019). Conclusion: Risk of having CAD increases many folds when subject has vitamin D deficiecy as well as high Lp'a'.