Analysis of 6,182 participants in the Young Finns Study revealed that lipoprotein(a) measured in molar concentration (nmol/L) and mass concentration (mg/dL) demonstrated comparable associations with coronary artery disease and cardiovascular events. For the highest versus lowest quintiles, odds ratios were 1.55 for molar and 1.67 for mass measurements, with nearly identical model discrimination capabilities. However, molar measurements aligned more closely with genetic risk scores and apolipoprotein(a) isoform size variations. The research addresses a critical clinical question since Lp(a) testing has become increasingly important for cardiovascular risk stratification, yet laboratories use different reporting units. This creates confusion for clinicians interpreting results across different testing facilities. The findings suggest both measurement approaches provide reliable cardiovascular risk assessment, potentially simplifying clinical decision-making regardless of which unit laboratories report. However, the superior genetic correlation with molar measurements supports ongoing efforts to standardize toward particle-based reporting. As this is a preprint awaiting peer review, these standardization recommendations may evolve. The work represents incremental but practically important progress in harmonizing Lp(a) testing protocols across healthcare systems.