Association of atherogenic low-density lipoprotein subfractions with carotid atherosclerosis.

Summary Patients with carotid atherosclerosis are at increased the greater the proportion of the more atherogenic LDL subfractions. Mean LDL score was significantly risk of both stroke and ischaemic heart disease. Lowdensity lipoprotein (LDL) is a heterogeneous group higher in diseased patients (mean±SD, 1.56±0.61) than the normal group (1.26±0.65) (t=2.12, p= of particles, with small, dense particles being more atherogenic. We studied 79 patients (51 men, 0.037). There was no significant association between LDL score and severity of carotid artery stenosis. mean±SD age 62.4±11.7 years) referred for Doppler ultrasound assessment of the carotid arter- Age (adjusted odds ratio 1.09, 95%CI 1.03‐1.15) and smoking history (2.09, 95%CI 1.10‐3.98) preies. Evidence of carotid atherosclerosis, defined as the presence of atherosclerotic plaque, stenosis or dicted carotid atherosclerosis in logistic regression analysis, with LDL score achieving borderline signiocclusion in one or more of the six carotid artery segments examined, was found in 44 patients (56%). ficance (2.20, 95%CI 0.91‐5.29). Small, dense LDL subfractions are associated with carotid atherosclerLDL subfractions were analysed by disc polyacrylamide gel electrophoresis with prior ultracentrifu- osis and may be a modifiable risk factor for stroke as well as ischaemic heart disease. gation of serum to remove chylomicrons. This method produces a LDL score; the higher the score,