The predictive value of lipid studies in patients undergoing cardiac catheterization and open heart surgery.

All patients admitted for cardiac catheterization prior to possible coronary bypass surgery have a lipid profile ordered as part of their preadmission laboratory work. These studies, usually the first and only performed on the patient, include: high and low density lipoprotein-cholesterol, total cholesterol, triglyceride, and apolipoproteins A-I and B. This study was designed to determine the diagnostic significance and sensitivity of these tests based on a one-time determination as predictors of coronary artery disease. The three groups studied included those patients with surgically confirmed coronary artery disease (n = 247), aortic and/or mitral stenosis (n = 34), and normals, those free of disease (n = 30). The total population was 311 subjects, ranging in age from 20-85 years, which comprised 250 males and 61 postmenopausal females. The prevalence of the disease was 77% over the total population, with 238 of those with coronary artery disease going on to bypass surgery. Surgical results of cardiac catheterization were collected as percent occlusion. No correlations were found between lipoproteins and percent occlusion in the diseased group. Calculations of sensitivity and specificity for various lipid values suggested no clinical use for a one-time determination of these apo- and lipoproteins.