Abstract
Although remnant-like lipoprotein particles (RLPs) are known to be atherogenic, the
relationship between serum RLP-cholesterol (RLP-C) level and coronary artery disease
(CAD) has not as yet been evaluated. This clinical study was aimed at investigating
the pathological significance of serum RLP-C among several coronary risk factors with
a clear focus on elderly patients. We took fasting venous blood samples to determine
lipid profiles including RLP-C from 188 patients with angiographically identified
CAD and 68 control patients. Overall analysis showed that the RLP-C/HDL-C ratio was
higher in both single-vessel CAD group (n = 67; p < 0.01) and multi-vessel CAD group
(n = 121; p < 0.001) compared to controls. Further, multiple logistic regression analysis
indicated that the diabetes, HDL-C and the RLP-C/HDL-C ratio could discriminate CAD
patients from controls. In patients younger than 65 years, diabetes, HDL-C, LDL-C
and the LDL-C/HDL-C ratio as well as the RLP-C/HDL-C ratio could discriminate CAD.
In patients 65 aged years or older, however, diabetes, triglyceride and RLP-C as well
as the RLP-C/HDL-C ratio could discriminate CAD, whereas LDL-C and the LDL-C/HDL-C
ratio could not. These results led us to believe that the contribution of a given
risk factor to the development of CAD in elderly patients may be different from that
in younger patients. In elderly patients, RLP-C rather than LDL-C was strongly associated
with the development of CAD. Accordingly, serum RLP-C levels may serve as a convenient
and reliable index for assessing CAD.
Key words
Remnant-like lipoprotein particles - Coronary artery disease - RLP-cholesterol - Risk
factor - Elderly patients
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T. Inoue, M. D.
Department of Cardiology · Koshigaya Hospital · Dokkyo University School of Medicine
·
2-1-50 Minamikoshigaya · Koshigaya City · Saitama 343-8555 · Japan
Phone: + 81 (489) 65-1111 ·
Fax: + 81 (489) 65-1127
Email: inouet@dokkyomed.ac.jp