Lipoproteins and Apolipoproteins in the Prediction of Coronary Artery Disease
Atherosclerotic cardiovascular disease is the leading cause of death and also the most frequent cause of early invalidity in most European countries. Clinical conditions such as coronary heart disease (angina pectoris, myocardial infarction, acute cardiac death), cerebrovascular insufficiency (apoplexy), and peripheral arterial occlusive disease (intermittent claudication, gangrene) become manifest following decades of asymptomatic development of atherosclerotic vascular stenosis. In evaluating coronary risk there is a distinction made between primary risk factors (hypercholesterolemia, nicotine abuse, hypertension) and secondary risk factors (diabetes mellitus, obesity, lack of physical activity). The primary risk factors are individually capable of producing clinical complications of atherosclerotic vascular disease. Secondary risk factors, as a general rule, evoke clinical complications only in conjunction with one or more other factors. Individual risk factors should not be viewed as isolated in the course of a disease, since they frequently occur in combination. The incidence of cardiovascular disease increases cumulatively with the presence of multiple risk factors. The concept of a multifactorial basis for the origin of atherosclerotic vascular disease is principally derived from the findings of epidemiological studies. It has been demonstrated quite convincingly in the example of acute cardiac death that risk factors can be identified in the overwhelming majority of cases and that individual risk factors are interrelated.
KeywordsCholesterol Obesity Filtration Carbohydrate Europe
Unable to display preview. Download preview PDF.
- 1.1985) Lowering blood cholesterol to prevent heart disease. Consensus Conference. JAMA 253: 2080–2086Google Scholar
- 2.Strategy for the prevention of coronary heart disease. A policy statement of the European Atherosclerosis Society. Eur Heart J (in press)Google Scholar
- 3.Kannel WB, Gordon T (1976) The Framingham study: an epidemiological investigation of cardiac disease: the results of the Framingham study applied to four other US based epidemiologic studies of cardiovascular disease. Publication (NIH) 76–1083, section 31. US Dept of Health, Education and WelfareGoogle Scholar
- 9.Assmann G, Schulte H (1986) Procam-trial. Panscientia, Zürich, 1986Google Scholar
- 10.Assmann G (1982) Lipidstoffwechsel und Atherosklerose. Schattauer, StuttgartGoogle Scholar
- 13.Schriewer H, Nolte W, Robeneck H, Assmann G (1986) Apolipoprotein B determination in the dissolved precipitate obtained after precipitation of LDL with polyvinylsulphate. An alternative method for the determination of LDL apolipoprotein B without using ultracentrifugation. J Clin Chem Clin Biochem 24: 347–352PubMedGoogle Scholar
- 16.Grundy SM (1984) Recommendations for the treatment of hyperlipidemia in adults. A joint statement for the nutrition committee and the council on arteriosclerosis of the American Heart Association. Arteriosclerosis 4: 445–468Google Scholar