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Article
October 7, 1988

Low-Density Lipoprotein Subclass Patterns and Risk of Myocardial Infarction

Author Affiliations

From the Donner Laboratory, Lawrence Berkeley Laboratory, University of California, Berkeley (Drs Austin and Krauss); the Laboratory of Biochemical Genetics and Metabolism, The Rockefeller University, New York (Dr Breslow); and the Departments of Medicine, Preventive Medicine, and Clinical Epidemiology, Brigham and Women's Hospital and Harvard Medical School (Drs Hennekens and Buring), and the Department of Epidemiology, Harvard School of Public Health (Dr Willett), Boston. Dr Austin is now with the Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle.

From the Donner Laboratory, Lawrence Berkeley Laboratory, University of California, Berkeley (Drs Austin and Krauss); the Laboratory of Biochemical Genetics and Metabolism, The Rockefeller University, New York (Dr Breslow); and the Departments of Medicine, Preventive Medicine, and Clinical Epidemiology, Brigham and Women's Hospital and Harvard Medical School (Drs Hennekens and Buring), and the Department of Epidemiology, Harvard School of Public Health (Dr Willett), Boston. Dr Austin is now with the Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle.

JAMA. 1988;260(13):1917-1921. doi:10.1001/jama.1988.03410130125037
Abstract

The association of low-density lipoprotein (LDL) subclass patterns with coronary heart disease was investigated in a case-control study of nonfatal myocardial infarction. Subclasses of LDL were analyzed by gradient gel electrophoresis of plasma samples from 109 cases and 121 controls. The LDL subclass pattern characterized by a preponderance of small, dense LDL particles was significantly associated with a threefold increased risk of myocardial infarction, independent of age, sex, and relative weight. Plasma levels of high-density lipoprotein cholesterol were decreased, and levels of triglyceride, very low—density lipoproteins, and intermediate-density lipoproteins were increased in subjects with this LDL subclass pattern. Multivariate logistic regression analyses showed that both high-density lipoprotein cholesterol and triglyceride levels contributed to the risk associated with the small, dense LDL subclass pattern. Thus, the metabolic trait responsible for this LDL subclass pattern results in a set of interrelated lipoprotein changes that lead to increased risk of coronary heart disease.

(JAMA 1988;260:1917-1921)

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