PLASMA TRIGLYCERIDES AND 3 LIPOPROTEIN CHOLESTEROL FRACTIONS ARE INDEPENDENT PREDICTORS OF THE EXTENT OF CORONARY ATHEROSCLEROSIS

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 greater than or equal to 50% narrowing were recorded as study end points. By extent of atherosclerosis, defined as the number of greater than or equal to 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, HDL(2) cholesterol, HDL(3) 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 HDL(2) cholesterol by 0.20 mmol/L or HDL(3) cholesterol by 0.46 mmol/L. The less sensitive coronary end point, presence of atherosclerosis (ie, observation of greater than or equal to 1 lesion of greater than or equal to 50%) depended significantly on age, sex, LDL cholesterol, and HDL(2) cholesterol, but not on HDL(3) cholesterol or triglycerides. Conclusions In addition to LDL, HDL(2), and HDL(3) cholesterol, triglycerides also proved independently predictive of the extent of coronary atherosclerosis.