A COMPARISON OF BLOOD LIPID AND LIPOPROTEIN VALUES IN YOUNG-ADULTS WHO DIE SUDDENLY AND UNEXPECTEDLY FROM ATHEROSCLEROTIC CORONARY-ARTERY DISEASE WITH OTHER NONCARDIAC DEATHS

Postmortem blood lipid and lipoprotein analyses were conducted in a ca se-controlled study of young adults (ages 22-43) who died suddenly and unexpectedly of atherosclerotic coronary artery disease in Allegheny County, Pennsylvania. None of the individuals in the study group (n = 28 cases) had a significant medical or cardiac history except in the i mmediate antemortem period. The control group (n = 31) consisted of ag e- and sex-matched cohorts who died of noncardiac related fatalities a nd who had no evidence of CAD. The results indicated a male-to-female ratio of nearly 30:1 with a marked predominance of young white men. Me an total cholesterol (241 mg/dL), triglycerides (583 mg/dL), and low-d ensity lipoproteins (LDL) (107 mg/dL) were all significantly elevated in the study group as compared to controls (p<0.001, p<0.018, and p<0. 001 for the three parameters, respectively). Mean Apolipoprotein B (98 .7 mg/dL) was also significantly elevated compared to control values ( p<0.001). By contrast, mean high-density lipoprotein values (36 mg/dL) were not significantly different from control values (p = 0.35), and mean values of Apolipoproteins Al (121 mg/dL) and A2 (37.6 mg/dL) were essentially identical to control values (p = 0.44 and p = 0.64, respe ctively). The differences in these biochemical markers between the two groups could not be explained by differences in postmortem interval o r by the presence of recently ingested food. These findings indicate t hat elevations of plasma cholesterol, triglycerides, LDL, and Apolipop rotein B are important biochemical markers for the development of earl y and apparently clinically silent yet life-threatening coronary arter y disease.