[Defective remnant clearance as a risk factor for coronary heart disease]

We investigated the metabolism of postprandial lipoproteins in four male patients who suffered from premature (less than 60 years) angiographically proven coronary heart disease. They had normal to low plasma total and low density lipoprotein cholesterol levels. Other risk factors were absent. Using the vitamin A fat loading test we were able to show that the clearance of chylomicron remnants was delayed compared to three healthy control subjects. It has been suggested that these postprandial lipoproteins may be atherogenic. Our data strongly favour the concept that defective removal of postprandial lipoproteins leads to the development of coronary heart disease in these patients.