title: Plasma triglycerides and type III hyperlipidemia are independently associated with premature familial coronary artery disease.
abstract: OBJECTIVE
  This study was designed to explore contributions of plasma total triglycerides (TGs) and type III hyperlipidemia to the risk of premature familial coronary artery disease (CAD).
  
  
  BACKGROUND
  Although plasma TGs are recognized as a risk factor for CAD, the independence of this association from related risk factors remains controversial. Also, the degree of CAD risk conferred by excess remnants of TG-rich lipoproteins in type III hyperlipidemia remains unclear.
  
  
  METHODS
  We analyzed lipids by ultracentrifugation in a series of 653 cases with premature familial CAD (myocardial infarction or revascularization by age 55 years in men or age 65 years in women, with similar onset in at least one other first-degree relative) and in 1,029 control subjects. The relationship of CAD risk to various strata of plasma TGs, high-density lipoprotein (HDL) cholesterol, and type III hyperlipidemia, and interactions among these variables were examined by multiple logistic regression, adjusting for other CAD risk factors.
  
  
  RESULTS
  The odds ratio for CAD with elevated plasma TG rose progressively to 11.4 in those with TGs 500 to 799 mg/dl (95% confidence interval 3.4 to 38.0, p < 0.0001) compared with <100 mg/dl, even after correction for HDL cholesterol, other elements of the metabolic syndrome, and other CAD risk factors. Risk of CAD associated with type III hyperlipidemia (found in 3.4% of cases) was also markedly increased independent of other risk factors (odds ratios of 5 to 10 depending on the model, all with p < 0.002).
  
  
  CONCLUSIONS
  The association between the plasma TG level and premature familial CAD is strong, graded, and independent. Risk of CAD is also strikingly elevated with type III hyperlipidemia.
authors.affiliation: Cardiovascular Genetics, Department of Internal Medicine, Cardiology Division, University of Utah School of Medicine, 410 Chipeta Way, Salt Lake City, UT 84108, USA. paul@ucvg.med.utah.edu
authors.forename: Paul N
authors.initials: PN
authors.lastname: Hopkins
authors.forename: Lily L
authors.initials: LL
authors.lastname: Wu
authors.forename: Steven C
authors.initials: SC
authors.lastname: Hunt
authors.forename: Eliot A
authors.initials: EA
authors.lastname: Brinton
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*; D014589:Utah / Q000453:epidemiology
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides