Vitamin E compared with other potential risk factor concentrations in patients with and without coronary artery disease: a case-matched study.

Thirty six individuals with angiographic evidence of coronary atherosclerosis and thirty six individuals without coronary disease, matched for a variety of cardiovascular risk factors including age, sex, smoking, hypertension, diabetes and family history, were evaluated for their serum concentrations of vitamin E, total cholesterol, triacylglycerols, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, apolipoprotein A-I, and apolipoprotein B. Apolipoprotein B, low density lipoprotein-cholesterol and total cholesterol concentrations were unequivocally higher in patients with coronary artery disease. Triacylglycerols were marginally higher in patients with disease. The antioxidant vitamin E (alpha-tocopherol) was significantly higher in patients with atherosclerosis when compared with controls (35.1 +/- 17.0 mumol/l vs. 29.0 +/- 13.2 mumol/l, p = 0.017). However, alpha-tocopherol concentrations were strongly associated with lipid concentrations and normalization to the total cholesterol concentrations produced ratios which were not significantly different in the two groups. Logistic regression analysis revealed that the association of lipid risk factors with coronary stenosis was determined primarily by the difference in total cholesterol values. This study demonstrated that in this group of patients referred for angiography and matched for other risk factors, higher alpha-tocopherol concentrations were associated with patients with coronary disease and were not useful for assessing risk of coronary artery disease.