[The lipid profile and coronary artery disease]

To correlate lipid profile with coronary artery disease (CAD).

One hundred patients with symptoms of CAD were studied by coronariography: 62 males (55.6 +/- 9.26 years) and 38 females (56.3 +/- 9.72 years). Blood glucose, total cholesterol (TC), triglycerides (TG), and HDL-C (n = 96) levels were determined; LDL-C was calculated by the Friedewald formula. Coronary artery stenotic and normal proximal lumen were measured with a pachymeter, and the percent degree of obstruction calculated. The proximal, medial and distal segments of left anterior descending (LAD), circumflex (CX), right coronary artery (RCA) and the coronary trunk, 1st LAD diagonal branch and 1st RCA marginal branch were analysed.

Coronariography: CAD was documented in 74 patients, (56-75.6% men), with > or = 50% stenosis in 67 (90.5%), 54 (79.1%) men. The lesions were univessel in 24 (33.4%), bivessel in 29 (39.7%), and trivessel in 20 (27.4%). Seventy patients had TC > or = 200 mg/dl, 29 (41.4%) > or = 240 mg/dl); 69 (71.9%) LDL-C > or = 130 mg/dl, 37 (38.5%) > or = 160 mg/dl; 35 (36.5%) HDL-C < 35 mg/dl and 10 TG > or = 200 mg/dl. Lipid profile vs CAD -1) CAD patients had lower HDL-C values (38.8 +/- 10 mg/dl vs 48.2 +/- 13.6 mg/dl, p = 0.01) and higher Castelli risk indexes (CRI) (TC/HDL-C = 5.9 +/- 1.7 vs 5.1 +/- 1.4 and LDL-C/HDL-C = 4.1 +/- 1.5 vs 3.4 +/- 1.2, p = 0.04); 2) > or = 50% stenosis and multivessel disease showed higher CRI (p = 0.01 and p = 0.04 for TC/HDL-C, and p = 0.01 and p = 0.02 for LDL-C/HDL-C, respectively). Twenty one (70%) of the 30 patients with TC < 200 mg/dl had CAD (28% of the patients with CAD), in whom there was a high frequency of patients with a low HDL-C level (11/21, 52.4% vs 3/9, 33%, p = 0.06).

Lower HDL-C and higher CRI values were associated with more severe and intensive CAD; TC < 200 mg/dl is compatible with CAD, specially if there is a low HDL-C level. These findings strengthen the need of HDL-C measurement for CAD risk assessment.