Circulation, Vol 62, 1212-1220, Copyright © 1980 by American Heart Association
RC Bahler, JJ Opplt and DM Waggoner
The relationship between the configuration of agarose-gel lipoprotein
electrophoresis patterns and the extent of coronary artery disease (CAD)
was studied in consecutive patients undergoing diagnostic coronary
angiography. Three groups were identified: patients with normal coronary
arteries (group 1), patients with minor luminal irregularities (group 2)
and patients with significant coronary artery obstructions (group 3).
Densitometric scans of the electrophoretograms were studied to determine
the relative proportion of lipoproteins in each major fraction and the
configuration of the pre-beta complex. The presence of multiple
subfractions within the pre-beta lipoprotein complex had a sensitivity of
66% for the presence of CAD and a specificity of 99%. A decreased level of
alpha 1 lipoproteins, defined as less than 25% of total lipoproteins,
occurred almost entirely in groups 2 and 3, whereas an increased level
(greater than or equal to 28%) of pre-beta lipoproteins was less specific
for CAD. The proportions of alpha and pre-beta lipoproteins were inversely
related (r = 0.677). Although abnormalities of serum cholesterol and/or
triglycerides were common in groups 2 and 3, the detailed study of
lipoprotein patterns provided a more sensitive index of disordered
lipoprotein metabolism. The angiographic severity of CAD was significantly
related to age and to levels of serum triglycerides, alpha 1 lipoproteins,
and pre-beta lipoproteins. The lipoprotein electrophoretogram, in
conjunction with serum lipid levels, is a valuable tool for demonstrating
abnormalities of lipoprotein metabolism associated with CAD.
ARTICLES
Lipoproteins in patients with proved coronary artery disease: qualitative and quantitative changes in agarose-gel electrophoretic patterns