The possible role of remnant-like particles as a risk factor for sudden cardiac death.
Postmortem plasma lipid and lipoprotein levels were analyzed in two groups of Japanese subjects who died suddenly and unexpectedly due to cardiac (n = 93) or non-cardiac (n = 26) causes. No individuals in either group had a significant medical or cardiac history. In this study, we measured plasma total cholesterol, triglycerides, VLDL-cholesterol, LDL-cholesterol, HDL-cholesterol, and especially triglyceride-rich lipoprotein remnants. Triglyceride and apo E-rich remnant-like particles (RLP) were studied as a possible risk factor for sudden cardiac death in relation to the progression of coronary atherosclerosis. The receiver-operating characteristic curve (ROC) analysis showed that RLP-TG was the most significant risk factor for sudden cardiac death among the lipids and lipoproteins and RLP-C was the best predictor for coronary atherosclerosis. HDL-C and LDL-C levels were within normal limits in the majority of the cases and did not appear to relate to the sudden cardiac death. Apo E phenotyping was performed for the detection of the genetic background in the lipid metabolism. The frequency of the Apo E3/3 (wild type) phenotype, which closely relates with the remnant metabolism, was significantly reduced in the sudden cardiac death group. Our study on the postmortem plasma lipid analysis suggested that RLP-C and RLP-TG are the best risk predictor for coronary atherosclerosis and sudden cardiac death, respectively.
Takeichi
S
S
Department of Forensic Medicine, Tokai University School of Medicine, Kanagawa, Japan.
Nakajima
Y
Y
Osawa
M
M
Yukawa
N
N
Saito
T
T
Seto
Y
Y
Nakano
T
T
Adachi
M
M
Jitsukata
K
K
Horiuchi
K
K
Wang
T
T
Nakajima
K
K
D000328:Adult; D000368:Aged; D053318:Apolipoprotein E3; D001057:Apolipoproteins E / Q000097:blood; D002784:Cholesterol / Q000097:blood; D003324:Coronary Artery Disease / Q000473:pathology*; D016757:Death, Sudden, Cardiac / Q000473:pathology*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014280:Triglycerides / Q000097:blood
D053318:Apolipoprotein E3; D001057:Apolipoproteins E; D008055:Lipids; D008074:Lipoproteins; D014280:Triglycerides; D002784:Cholesterol