Clearance of a chylomicron-like emulsion from plasma is delayed in patients with coronary artery disease.

To determine whether the metabolism of chylomicrons and their remnants is related to atherogenesis, a triglyceride-rich emulsion known to mimic chylomicron behavior in plasma and labeled with 1-14C-cholesteryl oleate was injected intravenously into 11 normolipidemic patients (triglycerides: 133 +/- 60 mg/dl; total cholesterol: 207 +/- 20 mg/dl; LDL: 143 +/- 20 mg/dl; VLDL: 27 +/- 13 mg/dl; and HDL cholesterol: 41 +/- 11 mg/dl; apo AI: 1.27 +/- 0.54 g/l and apo B: 1.42 +/- 0.31 g/l) with atherosclerotic coronary artery disease and into 11 control subjects (triglycerides: 109 +/- 32 mg/dl; total cholesterol: 190 +/- 38 mg/dl; LDL: 125 +/- 29 mg/dl; VLDL: 22 +/- 6 mg/ dl; and HDL cholesterol: 44 +/- 9 mg/dl; apo AI: 1.09 +/- 0.28 g/l and apo B: 1.09 +/- 0.28 g/l) without the disease. The emulsion (69% triolein, 23% lecithin, 6% cholesteryl oleate and 2% cholesterol) was injected intravenously at approximately 9:00 a.m., after a 12-h fast. The clearance of the emulsion label from plasma, expressed as fractional clearance rate (FCR), was lower in coronary artery disease compared to controls (0.019 +/- 0.005/min vs 0.036 +/- 0.018/min, respectively, P < 0.05). These results indicate that the rate of removal of chylomicron remnants is slower in patients with coronary artery disease.