Utilizing the isolated lipoprotein receptor syndecan (heparan/chondroitin sulfate proteoglycan, HS/CS-PG) from arterial endothelium and smooth muscle cell membranes and coating therewith a silica surface, we were able to observe the very earliest stages of arteriosclerotic plaque development, the so-called nanoplaque build-up, by ellipsometric techniques (patent EP 0 946 876). The arteriosclerotic nanoplaque is represented by the ternary aggregational complex of the HS-PG receptor, lipoprotein particles and calcium ions. The model was validated in several clinical studies [1,2] on cardiovascular high-risk patients applying their blood lipoprotein fractions and, among others, proved the inhibiting effect of Ginkgo biloba on nanoplaque formation. In eight high-risk patients who had undergone an aortocoronary bypass operation, the reduction of arteriosclerotic nanoplaque formation amounted to 11.9 +/- 2.5% (p <= 0.0078, non-parametric Wilcoxon-test for paired samples; median 10.6%) and of nanoplaque size to 24.4 +/-8.1% (p <= 0.0234, non-parametric Wilcoxon-test for paired samples; median 20.4%), respectively, in normal blood substitute solution with 2.5 mmol/1 [Ca2+] after a 2 month therapy with 2 x 120 mg Ginkgo biloba extract (EGb 761, Rokan (R) novo). Additionally, we could directly demonstrate and confirm the antioxidative capacity of ginkgo and its oxygen free radical scavenging effect by disclosing an upregulation of superoxide dismutase (SOD) activity of 15.7 +/- 7.0% (p <= 0.0391, non-parametric Wilcoxon-test for paired samples; median 16.2%) and a lowering of the quotient oxLDL/LDL by 17.0 +/- 5.5% (p <= 0.0234, non-parametric Wilcoxontest for paired samples; median 16.9%) after the 2 month medication regimen. Furthermore, we measured a significant decrease in lipoprotein(a) concentration falling from 52.4 +/- 8.2 to 42.0 +/- 9.9 mg/dl (p <= 0.0359, paired Student t-test). Altogether, these beneficial effects of Ginkgo biloba might have partially repaired endothelial dysfunction being responsible for the very earliest stages in arteriosclerosis and could present a basis for a mechanistic explanation of nanoplaque reduction under Ginkgo treatment. This further pleiotropic effect of Ginkgo illuminated for the first time in this biosensor-biomembrane approach has immediate relevance for the formation of arteriosclerotic plaques as well as for its prophylactic and therapeutic potential in patients.