Studies of male survivors of myocardial infarction. XII. Relation of serum lipids and lipoproteins to survival over a 10-year period.

The relation of serum cholesterol and standard S(t) lipoproteins to survival over a 10-year period was studied in a "good risk" group of 120 men, aged 31 to 83, who had survived myocardial infarction by at least three months. All subjects were free of other disorders that might affect survival and were not receiving therapy to alter their serum lipids.Ten-year survival from time of entry into the study was 35%. Age had no important influence on survival. Neither the level of the serum cholesterol nor of the lipoprotein fractions related to survival. Mode of coronary death, whether infarctional or sudden, was also unrelated to serum cholesterol.Although the incidence and age of onset of CHD is influenced by serum lipid levels, survival subsequent to infarction is not. Apparently serum lipids affect the rate of atherogenesis in the long silent preclinical stage, but in the short clinical stage other factors determine survival. This suggests that therapy to lower serum lipids, based on a specific diagnosis of the type of hyperlipoproteinemia, should be started early in life before clinical disease occurs.