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Familial lipoprotein disorders in patients with premature coronary artery disease

J J Genest1, S S Martin-Munley, J R McNamara

  • 1Lipid Metabolism Laboratory, U.S.D.A. Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111.

Circulation
|June 11, 1992
PubMed

Insights

Genetic lipoprotein disorders are common in premature coronary artery disease (CAD). Over half of patients with early CAD have a familial lipid disorder, including excess lipoprotein (a) and low HDL cholesterol.

Area of Science:

  • Cardiovascular Genetics
  • Lipid Metabolism
  • Atherosclerosis Research

Background:

  • Genetic lipoprotein disorders are linked to premature coronary artery disease (CAD).
  • Understanding familial lipid abnormalities is crucial for CAD risk assessment.

Purpose of the Study:

  • To determine the prevalence of genetic lipoprotein disorders in individuals with premature CAD.
  • To identify specific familial lipid abnormalities associated with early-onset CAD.

Main Methods:

  • Analyzed lipid profiles (cholesterol, triglycerides, LDL, HDL, apo B, apo A-I, Lp(a)) in 102 kindreds (603 subjects) with premature CAD.
  • Defined abnormal lipid levels based on age- and sex-specific norms (above 90th or below 10th percentile).
  • Compared lipid abnormalities in probands with premature CAD to age-matched controls.

Main Results:

  • 73.5% of probands with premature CAD exhibited abnormal lipid levels, compared to 38.2% in controls.
  • Hypoalphalipoproteinemia (low HDL cholesterol) was the most frequent abnormality (39.2%).
  • Defined familial lipoprotein disorders were identified in 54% of kindreds, with excess Lp(a), hypertriglyceridemia with hypoalphalipoproteinemia, and combined hyperlipidemia with hypoalphalipoproteinemia being most common.

Conclusions:

  • Familial lipoprotein disorders are present in over half of patients with premature CAD.
  • Specific lipid abnormalities like excess Lp(a) and hypoalphalipoproteinemia are significant risk factors.
  • Genetic factors play a substantial role in determining lipoprotein levels, influencing CAD risk.
Abstract

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