A COMPARISON OF BLOOD LIPID AND LIPOPROTEIN VALUES IN YOUNG-ADULTS WHO DIE SUDDENLY AND UNEXPECTEDLY FROM ATHEROSCLEROTIC CORONARY-ARTERY DISEASE WITH OTHER NONCARDIAC DEATHS

Postmortem blood lipid and lipoprotein analyses were conducted in a case-controlled study of young adults (ages 22-43) who died suddenly and unexpectedly of atherosclerotic coronary artery disease in Allegheny County, Pennsylvania. None of the individuals in the study group (n = 28 cases) had a significant medical or cardiac history except in the immediate antemortem period. The control group (n = 31) consisted of age- and sex-matched cohorts who died of noncardiac related fatalities and who had no evidence of CAD. The results indicated a male-to-female ratio of nearly 30:1 with a marked predominance of young white men. Mean total cholesterol (241 mg/dL), triglycerides (583 mg/dL), and low-density lipoproteins (LDL) (107 mg/dL) were all significantly elevated in the study group as compared to controls (p<0.001, p<0.018, and p<0.001 for the three parameters, respectively). Mean Apolipoprotein B (98.7 mg/dL) was also significantly elevated compared to control values (p<0.001). By contrast, mean high-density lipoprotein values (36 mg/dL) were not significantly different from control values (p = 0.35), and mean values of Apolipoproteins Al (121 mg/dL) and A2 (37.6 mg/dL) were essentially identical to control values (p = 0.44 and p = 0.64, respectively). The differences in these biochemical markers between the two groups could not be explained by differences in postmortem interval or by the presence of recently ingested food. These findings indicate that elevations of plasma cholesterol, triglycerides, LDL, and Apolipoprotein B are important biochemical markers for the development of early and apparently clinically silent yet life-threatening coronary artery disease.