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The approach to triglyceride levels in patients with coronary heart disease

Ilay Shani1, Avishay Elis2

  • 1Department of Internal Medicine "C", Beilinson Hospital, Rabin medical center, Petah Tikva, Israel.

European Journal of Internal Medicine
|June 11, 2025
PubMed

Insights

Most cardiovascular disease (CVD) patients have controlled triglyceride (TG) levels. However, diabetic patients with CVD require more attention and specific treatment strategies to manage TG levels effectively.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Syndrome

Background:

  • Residual cardiovascular risk persists despite aggressive low-density lipoprotein cholesterol (LDL-C) lowering, partly due to elevated triglyceride (TG) levels.
  • Cardiovascular heart disease (CHD) patients in Israel frequently do not achieve recommended LDL-C targets, even post-hospitalization.
  • Similar trends are observed for triglyceride levels in this patient population.

Purpose of the Study:

  • To investigate triglyceride levels in patients with cardiovascular heart disease (CHD).
  • To identify specific therapeutic regimens required for managing elevated TG levels in CHD patients.
  • To evaluate factors influencing TG levels, particularly very high levels.

Main Methods:

  • Retrospective cohort study sub-analysis of 10,540 CHD patients admitted for anginal syndrome (2020-2022).
  • Evaluation of demographic, clinical characteristics, TG levels, and lipid-lowering treatments (pre-admission, during hospitalization, and post-discharge).
  • Analysis of factors affecting TG levels, with a focus on severe hypertriglyceridemia (≥ 500 mg/dL).

Main Results:

  • Two-thirds of patients had TG levels < 150 mg/dL; 4-6% exhibited severe hypertriglyceridemia.
  • Among patients with TG ≥ 150 mg/dL, two-thirds had HbA1c > 6.4%, indicating uncontrolled diabetes.
  • Severe hypertriglyceridemia was associated with higher rates of uncontrolled diabetes mellitus; statin use was common, while fibrate use was low but higher in severe cases. Hospitalization showed no significant short-term treatment or TG level impact.

Conclusions:

  • The majority of cardiovascular heart disease (CHD) patients maintain controlled triglyceride (TG) levels.
  • Diabetic patients with CHD warrant increased clinical attention for TG management.
  • Enhanced patient education and stricter therapeutic policies are necessary for optimal TG control in CHD patients.
Abstract

Keywords:
Coronary heart diseaseDiabetes mellitusIcosapent-EthylLDL-CResidual cardiovascular riskTriglycerides

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