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(Circulation. 2000;101:227.)
© 2000 American Heart Association, Inc.

Brief Rapid Communications

Accumulation of Apolipoprotein C-I–Rich and Cholesterol-Rich VLDL Remnants During Exaggerated Postprandial Triglyceridemia in Normolipidemic Patients With Coronary Artery Disease

Johan Björkegren, MD, PhD; Susanna Boquist, MD; Ann Samnegård, MD; Pia Lundman, MD; Per Tornvall, MD, PhD; Carl-Göran Ericsson, MD, PhD; Anders Hamsten, MD, PhD

From the Atherosclerosis Research Unit, King Gustaf V Research Institute (J.B., S.B., A.H.), Division of Cardiology, Department of Medicine, Karolinska Hospital (S.B., P.T., A.H.), and Division of Cardiology, Department of Medicine, Danderyd Hospital, Karolinska Institute (A.S., P.L., C.-G.E.), Stockholm, Sweden.

Correspondence to Dr Johan Björkegren, Gladstone Institute of Cardiovascular Disease, San Francisco General Hospital, UCSF, PO Box 419100, San Francisco, CA 94141-9100. E-mail jbjorkegren{at}gladstone.ucsf.edu

Background—Exaggerated postprandial triglyceridemia is common in normolipidemic patients with coronary artery disease (CAD). Alterations in the composition of triglyceride-rich lipoproteins (TRLs) are likely to underlie this metabolic disturbance. However, the composition of very-low-density lipoproteins (VLDLs), which are the most abundant postprandial TRLs, has never been defined in CAD patients.

Methods and Results—We examined postprandial changes in the number and composition of VLDLs in middle-aged, normolipidemic CAD patients and control subjects. TRLs from 14 patients and 14 control subjects aged 45 to 55 years were subfractionated by density gradient ultracentrifugation into Svedberg flotation rate (Sf) fractions >400, 60 to 400, and 20 to 60. The VLDLs were separated from chylomicron remnants by immunoaffinity chromatography. In CAD patients, the postprandial concentrations of triglycerides and large (Sf 60 to 400) VLDL particles were elevated. In addition, their postprandial large VLDLs were enriched in apolipoprotein (apo) C-I and their postprandial small (Sf 20 to 60) VLDL remnants were enriched with apo C-I and cholesterol.

Conclusions—Perturbed handling of postprandial triglycerides in normolipidemic CAD patients involves the accumulation of apo C-I–rich large VLDL particles and the generation of small, apo C-I– and cholesterol-rich VLDL remnants.

Key Words: lipids • lipoproteins • atherosclerosis • myocardial infarction

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