Plant sterols, found in Benecol and Flora proactive, are associated with an increased risk of coronary artery disease

This study was published in Steroids 2015 Mar 23

Study title and authors:
Increased plant sterol deposition in vascular tissue characterizes patients with severe aortic stenosis and concomitant coronary artery disease.

Luister A, Schött HF, Husche C, Schäfers HJ, Böhm M, Plat J, Gräber S, Lütjohann D, Laufs U, Weingärtner O.
Klinik für Innere Medizin III¸Kardiologie, Angiologie und Internistische Intensivmedizin.

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25814070

Phytosterols are present in very small quantities in fruit and vegetables. The phytosterol content of plant sterol-enriched margarines (Benecol, Flora proactive etc) are higher by an order of magnitude of up to 841 times than the average vegetable (see here). Campesterol and sitosterol are types of phytosterols.

Oxyphytosterols are phytosterols that have gone rancid.

Cholestanol is a derivative of cholesterol.

The aim of the study (of 104 patients) was to evaluate the relationship between phytosterols, oxyphytosterols, lathosterol, cholestanol and cholesterol in patients with severe aortic stenosis (artery blockages), some of whom also had coronary artery disease who were scheduled for elective aortic valve replacement.

The study found:
(a) The ratio of campesterol-to-cholesterol was increased by 26% in plasma of patients with coronary artery disease compared to those without coronary artery disease.
(b) Sitosterol concentrations were increased by 38.8% in the tissues of patients with coronary artery disease compared to those without coronary artery disease.
(c) Campesterol concentrations were increased by 30.4% in the tissues of patients with coronary artery disease compared to those without coronary artery disease.
(d) Oxidized sitosterol-to-cholesterol ratios were up-regulated by 22.7% in the plasma of patients with coronary artery disease compared to those without coronary artery disease.
(e) Oxidized campesterol was increased by 17.1% in the aortic valve cusps (the triangular fold or flap of a heart valve) of patients with coronary artery disease compared to those without coronary artery disease.
(f) Neither cholestanol nor the ratio of cholestanol-to-cholesterol was associated with coronary artery disease.

Luister concluded: "Patients with concomitant coronary artery disease are characterized by increased deposition of plant sterols, but not cholestanol in aortic valve tissue. Moreover, patients with concomitant coronary artery disease were characterized by increased oxyphytosterol concentrations in plasma and aortic valve cusps".

Is it wise to consume margarines high in phytosterols (such as Benecol and Flora proactive) when the study suggests that phytosterols are associated with a higher risk of coronary artery disease?