Association of plasma triglyceride-rich lipoprotein remnants with coronaryatherosclerosis in cases of sudden cardiac death

Among the risk factors for coronary atherosclerosis, elevated LDL-C level i s best known. The action of lipoprotein lipase on triglyceride-rich lipopro teins produces remnant lipoprotein particles enriched in cholesterol and ap olipoprotein E (apo E). Apo E serves as the ligand for uptake of remnant li poproteins via the L.DL-receptor or the remnant receptor. In this study, po stmortem plasma total cholesterol, triglycerides (TG), VLDL-C, HDL-C, lipop rotein (a) [Lp(a)] and remnant-like lipoprotein particles (RLP)-cholesterol , RLP-TG, apolipoproteins B, C III and E were measured, together with LDL-C to assess their potential contribution to the severity of coronary and aor tic atherosclerosis of the 197 cases of sudden death (132 cardiac death and 65 non-cardiac death). In all cases, the severity of coronary atherosclero sis was determined at postmortem pathological examination. RLP-cholesterol (RLP-C) and LDL-C concentrations were significantly higher in cases with ad vanced coronary atherosclerosis compared with those without coronary athero sclerosis; respective median values were 13.5 vs 8.3 mg/dl (P < 0.001) and 140 vs 115 mg/dl (P < 0.05). RLP-C levels were more strongly correlated wit h the severity score of coronary atherosclerosis than LDL-C. (C) 1999 Elsev ier Science Ireland Ltd. All rights reserved.