The relationship between lipid profile after fat loading and coronary artery disease severity assessed by SYNTAX score

Dyslipidemia is an established risk factor for coronary artery disease (CAD). Despite this, only half of CAD patients present with fasting dyslipidemia. Some reports have linked postprandial lipemia to atherosclerosis. We aimed to test the relationship between postprandial lipid profile (after fat loading) and CAD severity assessed by the SYNTAX score.

We included 53 patients with documented CADs. We checked both fasting and postprandial (2 hours) lipograms after fat loading with 17 g/body surface area (m2). Then we assessed CAD severity via coronary angiography using the SYNTAX score. Our study is registered in clinicaltrials.gov (NCT03175393).

*53 patients with age 57.92 ± 7.82 were recuirted. 36 (68% ) of them were male .We observed a significant increase in postprandial triglycerides (TGs); TGs (154.30 ±73.23 vs. 128.07 ± 69.40 mg/dl; P < 0.001), very-low-density lipoproteins (VLDL) (30.85 ± 14.65 vs. 25.60 ± 13.93 mg/dl; P < 0.001) as well as a significant decrease in the postprandial level of total cholesterol (162.37 ± 45.86 vs. 168.26 ± 45.96 mg/dl; P = 0.03) in comparison to their fasting level.We found that the SYNTAX score had a significant positive moderate correlation with 2-hour postprandial TGs (r = 0.55; P < 0.001) and 2-hour postprandial VLDL (r = 0.50; P < 0.001). Based on the current study, predictors of high Syntax score were older age OR: 1.23( 1.11-3.47); P< 0.001, post-prandial triglyceride OR: 2.34 (1.89-5.66); P< 0.001 and post-prandial VLDL OR: 1.76( 1.50-3.49); P< 0.001

Postprandial lipograms, especially TGs, are significantly and positively related to CAD severity.