Lecithin-cholesterol acryltransferase activity in patients with coronary artery disease examined by coronary angiography.

This study grew out of observations of certain lecithin:cholesterol acyltransferase (LCAT) abnormalities in patients with atherosclerosis. We studied the interrelationships among LCAT, and total cholesterol, free and esterified cholesterol, cholesterol in individual lipoprotein fractions, triglycerides, phospholipids, free fatty acids, L-lactates in 90 angiographically examined patients with coronary artery disease and 30 control subjects without clinical manifestations of coronary artery disease. Results of the study showed LCAT activity to be significantly decreased (P < 0.05) in patients with single-, double-, or triple-vessel disease than in disease-free subjects. LCAT was also found to follow the stage of coronary artery disease in angiographically examined patients. Decreased LCAT activity was accompanied by lower high-density lipoprotein cholesterol, elevated ratio of unesterified to esterified cholesterol, and increased levels of L-lactates, free fatty acids, and low-density lipoprotein cholesterol. Total cholesterol and triglycerides were within or slightly above the normal limits. The results show LCAT to be a significantly better indicator of the risk of coronary artery disease than either total cholesterol or triglycerides.