Perfil lipídico e doença arterial coronária / The lipid profile and coronary artery disease

ABSTRACT

PURPOSE--To correlate lipid profile with coronary artery disease (CAD). METHODS--One hyndred patients with symptomn of CAD were studied by coronariography 62 males (55.6ñ9.26 years) and females (56.3ñ9.72 years). Blood glucose, total cholesterol (TC), triglycerides (TG), and HDL-C (n=96) levels were determined; LDL-C was calculated by the Friedewald formula. Coronary artery stenotic and normal proximal lumen were measured with a paquimeter, and the percent degree of obstruction calculated. The proximal, medial and distal segments of left anterior descending (LAD), circumflex (CX), right coronary artery (RCA) and the coronary trunk, 1st LAD diagonal branch and 1st marginal branch were analysed. RESULTS--Coronariography CAD was documented in 74 patients, (56-75,6 por cento men), with >=50 por cento stenosis in 67 (90.5 por cento ), 54 (79.1 por cento ) men. The lesions were univessel in 24 (33.4 por cento ), bivessel in 29 (39,7 por cento ), and trivessel in 20 (27.4 por cento ). Seventy patients had TC>=200mg/dl, 29 (41.4 por cento )>=240mg/dl; 69 (71.9 por cento ) LDL-C>=130mg/dl, 37 (38.5 por cento )>=160mg/dl; 35 (36.5 por cento ) HDL-C<35mg/dl and 10 TG>=200mg/dl. Lipid profile vs CAD - 1)CAD patients had lower HDL-C values (38.8ñ10mg/dl vs 48.2ñ13.6mg/dl,p=0.01) and higher Castelli risk indexes (CRI) (TC/HDL-C=5.9ñ1.7 vs 5.1ñ1.4 and LDL-C/HDL-C=4.1ñ1.5 vs 3.4ñ1.2,p=0.04); 2)>=50 por cento stenosis and multivessel disease showed higher CRI (p=0.01 and p=0.04 for TC/HDL-C, and p=0.01 and p=0.02 for LDL-C/HDL, respectively). Twenty one (70 por cento ) of the patients with TC<200mg/dl had CAD (28 por cento of the patients with CAD), in whom there was a high frequency of patients with a low HDL-C level (11/21, 52.4 por cento vs 3/9, 33 por cento , p=0.06). CONCLUSION--Lower HDL-C and higher CRI values were associated with more severe and intensive CAD; TC<200mg/dl is compatible with CAD, specially if there is a low HDL-C level. These findings strengthen the need of HDL-C measurement for CAD risk assessment