ATHEROGENICITY OF POSTPRANDIAL LIPOPROTEINS AND CORONARY HEART-DISEASE

Coronary artery disease remains a major cause of death in the United States. Most epidemiologic data indicate that elevated high-density lipoprotein cholesterol decreases and increasing low-density Lipoprotein cholesterol increases the risk of coronary artery disease. To attribute all coronary artery disease to these two variables, however, appears oversimplistic. Many patients with coronary artery disease have ''normal'' fasting lipid profiles and, in some studies, the majority of subjects with coronary artery disease had cholesterol levels less than 239 mg%. These findings suggest other contributing factors. Recent interest has focused on the changes in lipoproteins that occur in the postprandial period, changes not reflected in previous studies in which the lipid levels were determined in the ''fasting state.'' This article reviews metabolism of endogenous and exogenous triglyceride-rich lipoproteins and possible associations between changes in postprandial plasma lipids and coronary artery disease.