Circulation, Vol 90, 2230-2235, Copyright © 1994 by American Heart Association
H Drexel, FW Amann, J Beran, K Rentsch, R Candinas, J Muntwyler, A Luethy, T Gasser and F Follath
BACKGROUND--The lipoprotein system has manifold links to atherosclerotic
disease. LDL cholesterol is related to lesion formation and growth. The
cholesterol of HDLs is indicative of protection against atherosclerosis.
The status of triglycerides and of subfractions of high-density
lipoproteins as risk factors is less certain. Also, the magnitude of the
atherogenic/protective power of these factors is not known. METHODS AND
RESULTS--Five hundred patients (418 men and 82 women) were enrolled in an
angiographic study. A total of 1006 coronary lesions with > or = 50%
narrowing were recorded as study end points. By extent of atherosclerosis,
defined as the number of > or = 50% lesions, the study subjects were
allocated to one of four ordered categories with 0, 1 to 3, 4 to 6, or 7 to
10 lesions, respectively. Subfractions of HDL cholesterol were determined
by a dual precipitation method. By a polychotomous logistic regression
model, it was found that, besides age and sex, LDL cholesterol, HDL2
cholesterol, HDL3 cholesterol, and triglycerides were independently
predictive (P < .05) of the extent of coronary atherosclerosis. An
increase in age by 10 years was associated with an increase of the odds
ratio for falling into a higher-extent category by a factor of 1.64, and
the same increase of the odds ratio was obtained by increasing LDL
cholesterol by 0.92 mmol/L or triglycerides by 1.01 mmol/L and by
decreasing HDL2 cholesterol by 0.20 mmol/L or HDL3 cholesterol by 0.46
mmol/L. The less sensitive coronary end point, presence of atherosclerosis
(ie, observation of > or = 1 lesion of > or = 50%) depended
significantly on age, sex, LDL cholesterol, and HDL2 cholesterol, but not
on HDL3 cholesterol or triglycerides. CONCLUSIONS--In addition to LDL,
HDL2, and HDL3 cholesterol, triglycerides also proved independently
predictive of the extent of coronary atherosclerosis.
ARTICLES
Plasma triglycerides and three lipoprotein cholesterol fractions are independent predictors of the extent of coronary atherosclerosis
Department of Medicine, University Hospital Zurich, Switzerland.
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