Plasma lipid concentrations and subsequent coronary occlusion after a first myocardial infarction. The POSCH Group.

This study correlated plasma lipid values with angiographic evidence of progression to complete coronary occlusion. Baseline triglycerides (TGs), total cholesterol (Chol), high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, very low density lipoprotein (VLDL) cholesterol, and HDL/LDL and HDL/Chol ratios were compared with coronary angiograms taken at baseline, 3 and 5 years in a prospective angiographic study. Results were from part of the multicenter trial of plasma lipid reduction in patients after a single myocardial infarction (POSCH). Comparison of patient's baseline lipids in the absence or presence of a new total coronary occlusion at 3 years showed a significant difference (p = 0.01) in TGs of 197 +/- 147 versus 250 +/- 162 mg/dl (p = 0.02) and VLDL of 30 +/- 23 (n = 284) versus 40 +/- 30 (n = 49) mg/dl. Stratification by the mean HDL/Chol ratio (16%) demonstrated that baseline TG levels were significantly increased in patients with a new coronary occlusion by 3 years despite a higher HDL/Chol ratio. When measured at the 3-year visit, plasma TG (176 +/- 91 versus 212 +/- 146 mg/dl; p = 0.02) and VLDL (28 +/- 18 versus 35 +/- 29 mg/dl; p = 0.04) were significantly elevated in the presence of a new 3-year coronary occlusion. Stratification by the mean HDL/Chol ratio (16%) demonstrated that 3-year TG levels increased significantly in patients with a new 3-year coronary occlusion despite a higher HDL/Chol ratio.(ABSTRACT TRUNCATED AT 250 WORDS)