THE 80-YEAR-OLD patient appeared to be at high risk for myocardial infarction. Diagnosed with heterozygous familial hypercholesterolemia, the woman had a cholesterol level above 10.3 mmol/L (400 mg/dL)—and had for her entire life, as far as anyone knew.
So what brought her to the hospital? "She was having cosmetic surgery on her ankles so she could fit into her ballet slippers again," recalled Michael S. Brown, MD. "She'd never had a heart attack in her life."
On the other hand, noted Brown, a 1985 Nobel laureate who is professor of medical genetics at University of Texas Southwestern Medical Center in Dallas, it's far from unusual "to see people with cholesterol levels of 200 mg/dL [5.2 mmol/L] having heart attacks."
The enormous variations in cholesterol levels and their role in causing coronary artery disease were discussed during Brown's presentation at the annual meeting of the American Association for Clinical Chemistry/Canadian Society