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Triglycerides and risk of atherosclerotic cardiovascular disease: An update

Michel Farnier1, Marianne Zeller1, David Masson2

  • 1PEC2, EA 7460, University of Bourgogne Franche-Comté, 21000 Dijon, France; Cardiology Department, University Hospital Centre of Dijon Bourgogne, 21000 Dijon, France.

Archives of Cardiovascular Diseases
|February 6, 2021
PubMed

Insights

Elevated triglycerides are a key factor in residual cardiovascular risk, even with statin therapy. New research explores triglyceride-rich lipoproteins and their role in atherosclerosis, aiming for better treatments.

Area of Science:

  • Cardiology
  • Biochemistry
  • Genetics

Background:

  • Low-density lipoprotein cholesterol (LDL-C) is a primary target for treating atherosclerotic cardiovascular disease (ASCVD).
  • Residual cardiovascular risk persists despite intensive statin therapy, with elevated triglycerides indicating a significant contributing factor.
  • Triglyceride-rich lipoproteins (TRLs) and their remnants are increasingly recognized as atherogenic and a causal risk factor for ASCVD.

Purpose of the Study:

  • To provide an update on the biology, epidemiology, and genetics of triglycerides.
  • To review the association between elevated triglycerides and atherosclerotic cardiovascular disease risk.
  • To discuss novel therapeutic strategies for managing hypertriglyceridemia and reducing residual cardiovascular risk.

Main Methods:

  • Review of clinical trial data and genetic studies.
  • Analysis of epidemiological data on triglyceride levels and cardiovascular events.
  • Examination of emerging pharmacological interventions for hypertriglyceridemia.

Main Results:

  • Elevated triglycerides are a marker of residual cardiovascular risk on LDL-C-lowering therapy.
  • Genetic evidence strongly supports remnants of TRLs as a causal cardiovascular risk factor.
  • A recent trial demonstrated cardiovascular event reduction with icosapent ethyl, not solely explained by triglyceride lowering.

Conclusions:

  • Triglycerides and TRL remnants represent a significant, modifiable cardiovascular risk factor.
  • Novel drug development is crucial for addressing residual risk in patients with elevated triglycerides.
  • Understanding the multifaceted role of triglycerides is essential for comprehensive cardiovascular disease prevention and management.

Keywords:
Cardiovascular riskLipoprotéines riches en triglycéridesRemnantsRisque cardiovasulaireTriglyceride-rich lipoproteinsTriglyceridesTriglycérides

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