TY - JOUR
T1 - Plasma remnant-like lipoprotein particles or LDL-C as major pathologic factors in sudden cardiac death cases
AU - Nakajima, Katsuyuki
AU - Nakajima, Yasuhiro
AU - Takeichi, Sanae
AU - Fujita, Masaki Q.
N1 - Funding Information:
This study was supported in part by Grant-in-Aid from the Japan Society for the Promotion of Science, No. 17406023.
PY - 2008/5
Y1 - 2008/5
N2 - We have previously reported that the majority of sudden cardiac death (SCD) events were associated with postprandial hyperlipidemia in Japanese subjects. In this investigation, we have compared LDL-cholesterol (LDL-C) and remnant-like lipoprotein particles (RLP) as cardiovascular risk factors in SCD cases, especially in Pokkuri death syndrome (PDS) cases who had nearly normal coronary arteries. To predict the risk of plasma RLP-cholesterol, triglyceride (RLP-C, RLP-TG) and LDL-C in fatal clinical events associated with SCD cases with or without atherosclerosis (PDS), we calculated the cut-off values and likelihood ratio of these lipoproteins from ROC analysis. Sixty-eight percent of SCD cases were above cut-off value of RLP-C (>12.8 mg/dL) versus 32% for control death cases (P < 0.0001) and the likelihood ratio of RLP-C was 2.12. Significantly higher incidence of RLP-C above cut-off value (>10.1 mg/dL) was seen in PDS compared to controls (P < 0.0001) and the likelihood ratio was 3.13. Similarly, significantly higher incidence of RLP-TG above cut-off values, SCD > 53 mg/dL and PDS > 67 mg/dL, was seen compared to controls (P < 0.0001) and the likelihood ratio was 1.86 and 2.73, respectively. Further, significantly higher incidence of LDL-C above cut-off value (>93 mg/dL) was seen in SCD compared to controls (P < 0.0001) and the likelihood ratio was 1.68. However, the incidence of LDL-C above cut-off value (LDL-C > 106 mg/dL) was not significantly different between PDS and controls and the likelihood ratio was 1.52. In conclusion, this study has shown high levels of plasma remnant lipoproteins in PDS and that PDS cases did not present with atherosclerotic lesions or elevated LDL-C. In contrast, SCD cases showed high levels of plasma remnant lipoproteins together with elevated plasma LDL-C. Accordingly, we believe that plasma remnant lipoproteins level rather than plasma LDL-C is a major pathologic factor in cardiovascular events.
AB - We have previously reported that the majority of sudden cardiac death (SCD) events were associated with postprandial hyperlipidemia in Japanese subjects. In this investigation, we have compared LDL-cholesterol (LDL-C) and remnant-like lipoprotein particles (RLP) as cardiovascular risk factors in SCD cases, especially in Pokkuri death syndrome (PDS) cases who had nearly normal coronary arteries. To predict the risk of plasma RLP-cholesterol, triglyceride (RLP-C, RLP-TG) and LDL-C in fatal clinical events associated with SCD cases with or without atherosclerosis (PDS), we calculated the cut-off values and likelihood ratio of these lipoproteins from ROC analysis. Sixty-eight percent of SCD cases were above cut-off value of RLP-C (>12.8 mg/dL) versus 32% for control death cases (P < 0.0001) and the likelihood ratio of RLP-C was 2.12. Significantly higher incidence of RLP-C above cut-off value (>10.1 mg/dL) was seen in PDS compared to controls (P < 0.0001) and the likelihood ratio was 3.13. Similarly, significantly higher incidence of RLP-TG above cut-off values, SCD > 53 mg/dL and PDS > 67 mg/dL, was seen compared to controls (P < 0.0001) and the likelihood ratio was 1.86 and 2.73, respectively. Further, significantly higher incidence of LDL-C above cut-off value (>93 mg/dL) was seen in SCD compared to controls (P < 0.0001) and the likelihood ratio was 1.68. However, the incidence of LDL-C above cut-off value (LDL-C > 106 mg/dL) was not significantly different between PDS and controls and the likelihood ratio was 1.52. In conclusion, this study has shown high levels of plasma remnant lipoproteins in PDS and that PDS cases did not present with atherosclerotic lesions or elevated LDL-C. In contrast, SCD cases showed high levels of plasma remnant lipoproteins together with elevated plasma LDL-C. Accordingly, we believe that plasma remnant lipoproteins level rather than plasma LDL-C is a major pathologic factor in cardiovascular events.
KW - Cardiovascular events
KW - Coronary artery atherosclerosis
KW - Fatal clinical events
KW - LDL-C
KW - Pokkuri death syndrome
KW - Postprandial remnant hyperlipoporteinemia
KW - Remnant-like lipoprotein particle-TG
KW - Remnant-like lipoprotein particle-cholesterol (RLP-C)
KW - Sudden cardiac death
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U2 - 10.1016/j.atherosclerosis.2007.09.016
DO - 10.1016/j.atherosclerosis.2007.09.016
M3 - Article
C2 - 17977545
AN - SCOPUS:40949130514
SN - 0021-9150
VL - 198
SP - 237
EP - 246
JO - Atherosclerosis
JF - Atherosclerosis
IS - 1
ER -