LIPIDS, APOLIPOPROTEIN-E GENOTYPES AND OTHER RISK-FACTORS OF PATIENTSWITH CORONARY-ARTERY DISEASE IN CURACAO

We studied lipids, apolipoprotein-E (apo-epsilon) genotypes and other coronary artery disease (CAD) risk factors of 67 CAD patients (male/fe male ratio 5) in Curacao. Compared with 57 controls, male CAD patients had higher cholesterol, triglycerides, LDL-cholesterol, apo-B and dec reased HDL-cholesterol and HDL-cholesterol/cholesterol concentrations. Other CAD risk factors were: increased fasting glucose and HbA(lc) co ncentrations, decreased creatinine clearance, and increased prevalence s of lipoprotein (a) concentration >500 mg/l, renal disease, hyperhomo cysteinaemia, diabetes mellitus type II (DM-II), positive CAD family h istory and cigarette smoking. Male CAD patients had higher plasma alph a-tocopherol(eq). Compared with 29 female controls, female CAD patient s had higher fasting plasma glucose and HbA(lc) concentrations, and pr evalence of DM-II; Predicting factors for CAD development in the whole CAD group were: DM-II, cigarette smoking, apo-epsilon(3)/epsilon(4) a nd apo-epsilon(4)/epsilon(4). Apo-epsilon(4) was associated with lower HDL- and higher LDL-cholesterol concentrations. There is a need for l ocal studies on improvement of diabetic control, reference values of l ipoprotein (a) and homocysteine concentrations, on apolipoprotein (a) phenotypes, causes of hyperhomocysteinaemia, and dietary influences on CAD development in subjects who carry the apo-epsilon(4) allele.