Ischemic heart disease and hyperlipidemia.

Studies on lipid and lipoprotein abnormalities which are associable with ischemic heart disease were presented. None of the subjects studied for this report had clinical signs or symptoms characteristic to "familial or sporadic" hyperlipoproteinemia. Only few showed gross abnormalities in lipid chemistries which are compatible with these clinical entities. Lipid abnormalities characteristic to the majority of ischemic heart patients were modest to moderate increase of serum total and free cholesterol and triglyceride; either independent increase or combined increase of these lipid fractions. Determination of free cholesterol may favor to detect such minute abnormality in modest hyperlipidemia as seen in ischemic heart patients. As expressed by our lipoprotein PAG electrophoresis pattern, B and Bp pattern (Fig. 1) seemed to be important lipoprotein abnormalities because of high incidence of ischemic heart disease (60 to 65%). Another feature of these hyperbeta lipoproteinemic state without (B pattern) or with (Bp pattern) moderate prebeta lipoprotein is highly suggestive of premature onset of ischemic heart suggestive premature onset of ischemic heart disease in the subjects with these lipoprotein patterns. Pb battern (hyperpre-beta lipoproteinemic state) was the next, because of frequent occurrence of this pattern (approx. 30%) among the cardiovascular patients and relatively high incidence (approx. 40%) of ischemic heart disease. PB pattern (combine hyperpre-beta and hyperbeta lipoproteinemic state) occurred rarely but incidence of ischemic heart disease in the subject with this pattern was high (approx. 40%). Midband lipoprotein which is one of the unique lipoprotein species detected by PAG electrophoresis may possibly reflect disordered lipoprotein metabolism. However, its association with ischemic heart disease seemed highly unlikely. However, further studies on this and other unusual lipoproteins detectable with PAG electrophoresis seems productive. Extensive studies on cine coronary angiographically established subjects (well characterized study subjects) with this new method in addition to the others would be highly productive to obtain more reliable conclusion on this subject, and hence, to obtain more effective guide line for early identification or for prevention of coronary atherosclerosis.