THE POSSIBLE ROLE OF REMNANT-LIKE PARTICLES AS A RISK FACTOR FOR SUDDEN CARDIAC DEATH

Postmortem plasma lipid and lipoprotein levels were analyzed in two gr oups of Japanese subjects who died suddenly and unexpectedly due to ca rdiac (n = 93) or non-cardiac (n = 26) causes. No individuals in eithe r group had a significant medical or cardiac history. In this study, w e measured plasma total cholesterol, triglycerides, VLDL-cholesterol, LDL-cholesterol, HDL-cholesterol, and especially triglyceride-rich lip oprotein remnants. Triglyceride and apo E-rich remnant-like particles (RLP) were studied as a possible risk factor for sudden cardiac death in relation to the progression of coronary atherosclerosis. The receiv er-operating characteristic curve (ROC) analysis showed that RLP-TG wa s the most significant risk factor for sudden cardiac death among the lipids and lipoproteins and RLP-C was the best predictor for coronary atherosclerosis. HDL-C and LDL-C levels were within normal limits in t he majority of the cases and did not appear to relate to the sudden ca rdiac death. Apo E phenotyping was peIformed for the detection of the genetic background in the lipid metabolism. The frequency of the Apo E 3/3 (wild type) phenotype, which closely relates with the remnant meta bolism, was significantly reduced in the sudden cardiac death group. O ur study on the postmortem plasma lipid analysis suggested that RLP-C and RLP-TG are the best risk predictor for coronary atherosclerosis an d sudden cardiac death, respectively.