THE PLASMA LIPIDS IN CORONARY ARTERY DISEASE

Abstract

In the vast majority of patients coronary artery disease is a manifestation of atherosclerosis. Many diseases that favour the development of atherosclerosis are associated with disturbances in the plasma lipids The lipid composition of atherosclerotic plaques and of plasma is similar enough to suggest that the lipids of the plaques may have their origin in the plasma (Weinhouse and Hirsch, 1940; Buck and Rossiter, 1951) and labelled cholesterol studies have shown that this plasma lipid is, in fact, incorporated into the atherosclerotic plaque (Biggs et al., 1952). Less comprehensive studies of the plasma lipids in normal subjects compared with patients with coronary artery disease have been made in the United States (Morrison et al., 1948; Gertler et al., 1950; Steiner et al., 1952). It was thought that a larger study, precisely controlled in respect of age and sex, would be of value especially if conducted in Britain where the dietary habits differ to some extent from those elsewhere. METHOD The subjects were 200 consecutive admissions with coronary artery disease and 200 miscellaneous inpatient controls. In the coronary artery disease group, there was electrocardiographic confirmation of myocardial infarction in 170, and of ischmmia before or after the Master two-step test in 30 who presented clinically with angina of effort; any subject who lacked cardiographic confirmation of coronary artery disease was excluded. Adequate controls were very difficult to obtain from a hospital population, but were care- fully selected from convalescent in-patients, who had no history or clinical features of atherosclerosis, cardiac, hepatic, metabolic, or renal disease, nor of any other condition known to influence the plasma lipids. The coronary artery disease group was completed first, and the mean age of each decade of both sexes was determined; the control group was then completed so that the mean age, and number of cases in each decade, would correspond with the coronary artery disease group.