Lipid Risk Factor Correlates of Ischemic Heart Disease as Diagnosed by Myocardial Perfusion Scintigraphy

Abstract

Patients with known coronary artery disease frequently change their lifestyles (e.g., diet, exercise, and smoking habit) after the diagnosis is made. Such changes can alter lipid risk factor levels and obscure etiologic risk factor associations with the presence of coronary artery disease. It is therefore preferable to determine the contribution of potential risk factors before the diagnosis of coronary artery disease has been established. In this trial, we used stress nuclear myocardial perfusion imaging to diagnose coronary artery disease in patients presenting for evaluation of chest pain. Two groups of age- and sex-matched patients were identified: a normal group (patients with no evidence of coronary artery disease), and an abnormal group (patients whose scans indicated the presence of significant coronary artery disease due to either fixed or reversible perfusion defects). Blood samples were drawn before scanning and analyzed for lipid risk factors. Compared to the normal group, the abnormal group had higher levels of triglycerides (189±91 vs. 135±51 mg/dL, p=0.003), lower levels of high-density lipoprotein cholesterol (39±9 vs. 45±14 mg/dL, p=0.037), and higher levels of small, dense low-density lipoprotein (LDL(3)) (42±18 vs. 32±13 mg/dL, p=0.007). Total cholesterol, low-density lipoprotein, and lipoprotein(a) levels were similar between groups. These findings suggest that ischemic heart disease, as assessed by myocardial perfusion scintigraphy, is more closely associated with the low high-density lipoprotein/high triglyceride syndrome than with increased low-density lipoprotein or total cholesterol levels. (c) 2000 by CHF, Inc.

Atorvastatin Reduces Remnant Lipoproteins and Small, Dense Low‐Density Lipoproteins Regardless of the Baseline Lipid Pattern

“…Fasting plasma lipids and lipoproteins were analyzed as previously described 24 . Apo AI and apo B‐100 levels were determined in whole plasma by immunoprecipitation on the Cobas FARA using commercial antibody reagent kits from INCSTAR (Stillwater, MN).…”

“…Fasting plasma lipids and lipoproteins were analyzed as previously described. 24 Apo AI and apo B-100 levels were determined in whole plasma by immunoprecipitation on the Cobas FARA using commercial antibody reagent kits from INCSTAR (Stillwater, MN). Lipoproteins were isolated simultaneously in parallel tubes in a TL-100 ultracentrifuge (Beckman Instruments, Brea, CA) using a TLA-100.3 rotor.…”

“…LDL from fasting plasma was separated into three subfractions of increasing density (LDL 1 -LDL 3 ) by density gradient ultracentrifugation as described. 24 LDL 3 is synonymous with sd-LDL. Together, these three fractions constitute "true" LDL.…”

Dietary intake of n–3 long-chain polyunsaturated fatty acids and coronary events in Norwegian patients with coronary artery disease

“…At the same time, there was a higher frequency of smoking and ACS, and less use of acetylsalicylic acid and statins before angiography (data not shown), in the lowest quartile. Thus, both response rate and n23 LCPUFA intake appeared to be highest among those with stable angina, who already might have changed their lifestyle habits as a consequence of known disease (29). It is therefore possible that the incidence rate among these patients would have been greater if they had not increased their n23 LCPUFA intake.…”