Lipoprotein Subclasses in the Monitored Atherosclerosis Regression Study (MARS)

Abstract

Abstract Accumulating evidence suggests that triglyceride-rich lipoproteins contribute to coronary artery disease. Using data from the Monitored Atherosclerosis Regression Study, an angiographic trial of middle-aged men and women randomized to lovastatin or placebo, we investigated relationships between lipoprotein subclasses and progression of coronary artery atherosclerosis. Coronary artery lesion progression was determined by quantitative coronary angiography in low-grade (f ] 0 to 3), IDL (S _f 12 to 20), all VLDL subclasses (S _f 20 to 60, S _f 60 to 100, and S _f 100 to 400), and peak LDL flotation rate were significantly related to the progression of coronary artery lesions, specifically low-grade lesions. Greater baseline levels of HDL ₃ were related to a lower likelihood of coronary artery lesion progression. In multivariate analyses, small VLDL (S _f 20 to 60) and HDL ₃ mass were the most important correlates of coronary artery lesion progression. These results provide further evidence for the importance of triglyceride-rich lipoproteins in the progression of coronary artery disease. In addition, these results present new evidence for the possible protective role of HDL ₃ in the progression of coronary artery lesions. More specific information on coronary artery lesion progression may be obtained through the study of specific apolipoprotein B–containing lipoproteins.