Relation of Serum Lipid Levels to the Presence and Severity of Angiographic Coronary Artery Disease in Japanese

The prognostic value of serum lipids as coronary risk factors was determined in 665 patients (442 men and 223 women) who were examined by coronary angiography. The severity of coronary sclerosis was rated on a coronary sclerosis index (CSI) by scoring luminal narrowing in each segment from 0 to 6 and multiplying the obtained score by the number of coronary segments involved as classified according to the AHA; this method was previously reported by Fujinami et al. The subjects were stratified by gender and age, and categorized into either the normal coronary group (CSI of 0) or the coronary sclerosis group (CSI of more than 1). Serum lipids were estimated by conventional methods after a 14-hour fast at least one week after the discontinuation of all medication.We obtained the following results:1. CSI increased with age in a linear fashion in men but was exponentially elevated after 60 years of age in women, as shown in Fig. 1.2. Serum lipids determined by gender, age and severity of coronary sclerosis are listed in Table 1. In the CAD group, a significantly low HDL cholesterol level was found in men between 40 and 50 years of age and in women older than 60 years. When HDL and LDL cholesterol levels were combined as shown in Figs. 2 and 4, it was revealed that a low HDL cholesterol level was contributed more to the development of coronary sclerosis than LDL cholesterol in men below 60 years old and in women over 50 years old.In conclusion, HDL cholesterol, which participates in reverse cholesterol transport, is strongly associated with the presence and severity of coronary sclerosis in both genders.