RELATION OF THE LEVEL OF HIGH-DENSITY-LIPOPROTEIN SUBFRACTIONS TO THE PRESENCE AND EXTENT OF CORONARY-ARTERY DISEASE

Plasma lipid profiles, including high-density lipoprotein (HDL) subfractions HDL2 and HDL3, were obtained in 115 men undergoing coronary angiography to assess the relation of lipid levels to coronary artery disease (CAD). CAD was present in 87 patients (76%) and absent in 28 (24%). The largest difference between the 2 groups was observed for HDL2 cholesterol, with a mean of 0.13 mmol/liter (5 mg/dl) in patients with CAD compared with 0.25 mmol/liter (10 mg/dl) in those without CAD (p < 0.005). Smaller differences were found for HDL3 (1.02 mmol/liter [39 mg/dl] vs 1.19 mmol/liter [46 mg/dl]; p < 0.005) and HDL (1.15 vs 1.42 mmol/liter [45 vs 55 mg/dl]; p < 0.001) cholesterol, and apolipoprotein A-1 (1.37 vs 1.50 g/liter, p < 0.01) and plasma triglycerides (1.79 vs 1.38 mmol/liter [159 vs 122 mg/dl]; p < 0.05). No significant difference was found for plasma and low-density lipoprotein cholesterol, and apolipoprotein B levels. Simple regression analysis revealed that the most powerful independent variable associated with the extent of CAD was HDL2 cholesterol (Spearman rho = 0.311; p < 0.001). Stepwise multiple regression analysis proved HDL2 cholesterol and age to be the strongest predictors of extent of CAD. The level of HDL2 cholesterol was reason. ably well correlated with HDL cholesterol (r2 = 0.6; p < 0.0001), but less so with plasma apolipoprotein A-1 (r2 = 0.4; p < 0.0001). The data add to the growing body of information demonstrating an important association of HDL (and more specifically HDL2) with CAD in men.