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Increased Cardiovascular Risk in Hypertriglyceridemic Patients With Statin-Controlled LDL Cholesterol

Gregory A Nichols1, Sephy Philip2, Kristi Reynolds3

  • 1Kaiser Permanente Center for Health Research, Portland, Oregon.

The Journal of Clinical Endocrinology and Metabolism
|June 1, 2018
PubMed

Insights

High triglyceride levels increase cardiovascular disease risk in statin-treated patients with controlled LDL-C. This study highlights the importance of managing triglyceride levels for high-risk individuals.

Area of Science:

  • Cardiology
  • Epidemiology
  • Pharmacology

Background:

  • Real-world data on high triglyceride (TG) and cardiovascular disease (CVD) risk in statin-treated patients with controlled low-density lipoprotein cholesterol (LDL-C) is limited.
  • Understanding this relationship is crucial for optimizing CVD prevention strategies.

Purpose of the Study:

  • To compare the risk of CVD and mortality between patients with high TG levels and those with normal TG levels.
  • To provide real-world evidence on the impact of TG levels on cardiovascular outcomes in a specific patient population.

Main Methods:

  • A longitudinal observational cohort study was conducted within an integrated delivery system.
  • Patients aged ≥45 years with diagnosed CVD, on statin therapy, and with LDL-C between 40-100 mg/dL were included.
  • TG levels were categorized as normal (<150 mg/dL) or high (200-499 mg/dL) in 2010, with follow-up through 2016.

Main Results:

  • The study included 14,481 patients with normal TG and 2702 with high TG.
  • High TG levels were associated with a 10% greater adjusted incidence of a composite outcome including nonfatal myocardial infarction (MI), stroke, unstable angina, and revascularization (RR 1.10, P=0.041).
  • Specific drivers included nonfatal MI (RR 1.20), coronary revascularization (RR 1.18), and peripheral revascularization (RR 1.56).

Conclusions:

  • High triglyceride levels are associated with increased cardiovascular disease risk in high-risk, statin-treated patients with atherosclerotic CVD.
  • These findings underscore the importance of TG management in addition to LDL-C control for preventing CVD events.
Abstract

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