Apoproteins B and A-I and coronary artery disease in humans.

T his review initially will consider the association between premature coronary artery disease and abnormal lipoprotein cholesterol levels, but then focus on recent evidence linking the apoproteins of lipoproteins to atherosclerosis.This evidence suggests that although cholesterol is the major component common to the plasma and the arterial wall, plasma apoproteins may serve as a better marker of risk for atherosclerosis. HyperlipidemiaThe association between serum cholesterol levels and atherosclerosis in humans was suggested when Thannhauser and Muller in 1938 each demonstrated familial aggregation of individuals with tendon xanthomata, hypercholesterolemia, and coronary artery disease (CAD). 1 The association was generalized by studies such as those in Framingham which demonstrated that the risk for coronary artery disease rose over the entire range of serum cholesterol.This relation was seen predominantly in those persons 30 to 49 years of age at entry into the study 2 and most markedly in those 30 to 39 years old. 34Different lipoproteins affect risk differently.Among subjects 49 years and older, low density lipoprotein (LDL) cholesterol was associated with moderate CAD risk, 5 as had been suggested earlier by Gofman et al.; 6 however, in these older individuals, the high density lipo-