Lipids and lipoproteins in symptomatic coronary heart disease. Distribution, intercorrelations, and significance for risk classification in 6,700 men and 1,500 women. The Bezafibrate Infarction Prevention (BIP) Study Group, Israel
Open accessAbstract
BACKGROUND: Lipid and lipoprotein profiles of coronary heart disease (CHD) patients have usually not included data on high density lipoprotein cholesterol (HDL-C), except in small groups, and have not included information on women. Both aspects are meaningful in the evaluation of patients for risk classification and for the importance of HDL-C in dictating further evaluation. METHODS AND RESULTS: In the screening phase of a clinical trial, we obtained lipid and lipoprotein levels under Centers for Disease Control-standardized procedures in more than 6,700 men and 1,500 women aged 40-72 years. Mean total cholesterol (TC) was higher in women (by 15-24 mg/dl) but changed little with age. Mean HDL-C, however, progressively increased with increased age for both sexes (34.4 at age of less than 50 years to 37.5 mg/dl at age 65 or older in men and from 41.3 to 44.5 mg/dl for the respective age groups in women). Triglycerides (TG) were lower in elderly groups, particularly in men (151 mg/dl in 65-year-olds versus 189 in counterparts less than 50 years). The number of previous infarctions, severity of congestive heart failure, and severity of angina were negatively correlated with mean HDL-C in a dose-response manner, whereas the association with mean TG was inverted, creating a mirror image of that observed with HDL-C. More than half of patients (52%) with TC less than 200 mg/dl exhibited HDL-C levels consistent with the accepted "high-risk" range of less than 35 mg/dl, whereas an increasing percentage of desirable HDL-C level was found with increasing levels of TC (14% with HDL-C greater than or equal to 45 mg/dl at TC less than 200 mg/dl increasing gradually to 28% in patients with TC greater than 260 mg/dl). CONCLUSIONS: These results provide previously unavailable information on the lipid profile of female patients and appear to strongly establish the case for obtaining all three standard blood lipid determinations (TC, HDL-C, and TG) in coronary patients as well as in the framework of detecting and classifying individuals at high risk for CHD.
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Mendelian randomization studies suggest that PCSK9 inhibition may increase diabetes risk through an LDL-C-related effect, as appears to occur with statins.
“Mendelian randomization studies have also suggested that PCSK9 inhibition may increase the risk of DM with an LDL-C-related effect, as apparently occurs for statins [294].”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [294]
The Helsinki Heart Study reported significant reduction in CVD outcomes with gemfibrozil, but FIELD and ACCORD did not show reduction in total CVD outcomes.
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From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [267]
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- Venue
- Circulation
- Published
- 1992-09
- Volume
- 86
- Issue
- 3
- Pages
- 839-848
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
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- W2530251551
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- 21
- Citations by year
- 2025: 1 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 9 · 2015: 3 · 2012: 2
- FWCI
- 7.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Keywords
- coronary artery disease, lipid profile, HDL cholesterol, triglycerides, total cholesterol, lipoproteins, cardiovascular risk classification, sex differences, age-related changes, infarction, angina pectoris, congestive heart failure, dyslipidemia screening, lipoprotein distribution
- MeSH terms
- Adult, Aged, Cholesterol, Coronary Disease, Female, Humans, Lipids, Lipoproteins, Cholesterol, HDL, Male, Middle Aged, Risk Factors, Triglycerides
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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