Progression and regression of human coronary atherosclerosis. The role of lipoproteins, lipases and thyroid hormones in coronary lesion growth

Abstract

Relations between lipoprotein fractions, lipoprotein lipase activities, thyroid hormones and coronary lesion growth were studied among 35 male patients with severe coronary atherosclerosis, who had participated in the lipid lowering, dietary Leiden Intervention Trial. Coronary arteriographies were performed at the beginning of the study and 2 years later at termination. The coronary anatomy was quantitated with a computer-based analysis system to assess the progression rate of coronary atherosclerosis on the basis of the absolute arterial dimensions in a patient's coronary tree; for these purposes an absolute coronary score was computed. On the basis of the absolute coronary scores, the entire group of patients could be divided into a no lesion growth group (14 patients) and a progression group (21 patients). Lipoprotein fractions, lipoprotein lipases and thyroid hormones were determined at the end of the trial. No significant difference was found between the no lesion growth and progression groups of patients for total cholesterol (TC) and LDL-cholesterol (LDL-C). The VLDL-cholesterol (VLDL-C) and triglycerides (TG) were significantly higher (P less than 0.05) and HDL-C was almost significantly lower (P less than 0.10) in the progression group. Hepatic lipase (HL) values were significantly higher in the no lesion growth group, as compared to the progression group, whereas lipoprotein lipase (LPL) values were not significantly different. Triiodothyronine (T3) was significantly lower (P less than 0.01) in the progression group. Multivariate regression analysis showed HL to be the most important determinant of changes in coronary atherosclerotic lesions. T3 and HDL were also independently inversely related to coronary atherosclerotic lesion growth.(ABSTRACT TRUNCATED AT 250 WORDS)