WILLIAM J. PIERCE, M.D., F.A.C.P.
To the editor: Although cholesterol certainly enters into the pathogenesis of atherosclerosis (Dayton and associates, Ann Intern Med 72:97-109, 1970), I question its etiologic significance. Importance of polyunsaturated fats has long been under review (1). Kingsbury and associates (2) related low levels of linoleic acid in plasma-cholesteryl-esters to occlusive elements of ischemic heart disease and later found this abnormal pattern associated with increased risk of myocardial infarction, irrespective of type or degree of arterial disease, age, plasma cholesterol, or blood sugar concentrations. Horton (3) reviewed the widespread physiological role of prostaglandins. Prostaglandin effect on platelet aggregation seems to answer Dr.
WILLIAM J. PIERCE. Cholesterol vs Polyunsaturated Fats in Atherosclerosis. Ann Intern Med. 1970;73:657. doi: 10.7326/0003-4819-73-4-657_1
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Published: Ann Intern Med. 1970;73(4):657.
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