I just found out today that one of the people I train with recently had triple bypass surgery(no, not Richard my Paleo brother). He is a young guy(around 45 or so I would guess) with 2 young children around the same age as mine. One artery was 99% closed and 2 others were 90% closed. He found this out after getting a routine cholesterol check. His HDL was low and triglycerides was nearly 500! After the Doctors had a look around when trying to stent he had emergency bypass surgery the next day.
This fits the typical pattern I have heard of where the ratio of trigs/HDL being a good predictor of heart disease. The high ratio isn't a cause, but rather a marker of the inflammation state, which in this case was not so good. Very, very lucky to have been caught with no significant issues and now has a new lease on life.
My wife sees this quite a bit in her work. In her words "I keep seeing people with heart disease that are younger and younger every year".
If only my cousin Eugene was so lucky. About a week after he died I heard that the autopsy revealed 3 completely blocked arteries in his heart and that he died from a "massive heart attack".