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Total cholesterol level, high-density lipoprotein (HDL) cholesterol level, and the ratio of total cholesterol/HDL cholesterol and triglyceride level were determined in 128 consecutive patients undergoing coronary arteriography for evaluation of chest pain. Greater than 50% occlusive coronary artery disease was more prevalent in patients with either a high total cholesterol level, triglyceride level, or total cholesterol/HDL ratio, or a low HDL cholesterol level. Closer analysis of the extent of occlusive coronary artery disease indicated that the HDL cholesterol level was a better predictor of coronary artery disease than total cholesterol or triglyceride levels. The ratio of total cholesterol/HDL cholesterol, however, had a wider discrimination in identifying patients with both single-vessel or multivessel disease. This ratio should be a useful adjunct in assessing the risk of coronary artery disease.
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