Plasma lipids, lipoproteins and apolipoproteins and sudden cardiac death.

Abstract

To investigate the risk factors for sudden cardiac death, in particular that triggered by coronary heart disease, we analysed 17 different lipids, lipoproteins and apolipoproteins in the plasma of patients who had suffered sudden death, including sudden cardiac death. Studies were carried out on 107 cadavers comprising 78 subjects where the cause of death was diagnosed as sudden cardiac death and 29 subjects diagnosed with other causes of sudden death. All 107 cases were classified into four groups according to the degree of coronary stenosis and the degree of cardiac hypertrophy. Plasma levels of total cholesterol (T-CHOL), triglyceride (TG), beta-lipoprotein (beta-LIPO), free fatty acid, phospholipid, free cholesterol, high density lipoprotein cholesterol, lipoprotein(a) [Lp(a)], lipoproteins (VLDL, LDL, HDL) and apolipoproteins (apoAI, apoAII, apoB, apoCII, apoCIII, apoE) were determined. The level of apoB showed a significant difference and positive correlation with the degree of coronary stenosis by two different statistical methods, while the levels of T-CHOL, TG, beta-LIPO, VLDL, apoCII, apoCIII and apoE showed significant differences with the degree of coronary stenosis by one statistical method. It was concluded that a high plasma level of apoB is a risk factor for coronary stenosis, with higher levels resulting in more severe degrees of coronary stenosis. Furthermore, a significant difference was found regarding only apoCIII both between the sudden cardiac death group and the sudden death from other causes group, and between each of the four groups classified according to the degree of coronary stenosis. It was thus concluded that a high plasma level of apoCIII indicates the possibility of a coronary stenotic origin for sudden cardiac death.