Lipid and carbohydrate abnormalities in patients with angiographically documented coronary artery disease

An increased incidence of both abnormal lipoprotein patterns and abnormal reactions to glucose tolerance tests was found in 134 patients with documented coronary artery disease. Fifty-four per cent had an abnormal lipoprotein pattern and 67 per cent an abnormal response to an intravenous glucose tolerance test. Of subjects under age 50, 96 per cent had one or both of the metabolic abnormalities and 80 per cent had an abnormal lipoprotein pattern. The lipoprotein abnormalities were almost equally divided between type II (29 per cent) and type IV (25 per cent) patterns. The presence of a carbohydrate abnormality did not alter the age of appearance of coronary artery disease, but both the type II and type IV lipoprotein abnormalities decreased the mean age of appearance by approximately seven years. The morphologic features of the atherosclerosis as revealed by coronary angiography did not appear to differ among the different metabolic groups. The importance of determining specific metabolic abnormalities is stressed as (1) an aid in predicting risk from coronary artery disease, (2) an aid in making diagnoses in patients with chest pain and (3) a guide to rational therapy in patients with coronary artery disease.