Abstract Context Real-world evidence of the relationship between high triglyceride (TG) levels and increased cardiovascular disease (CVD) risk among statin-treated patients with LDL cholesterol (LDL-C) control is lacking. Objective We aimed to compare the risk of CVD and mortality between patients with high vs. normal TGs. Design Longitudinal observational cohort study. Setting Integrated delivery system. Patients Patients aged >45 whose TG level was either <150 mg/dL (normal) or between 200-499 mg/dL (high) in 2010, were taking only statins, had LDL-C values 40-100 mg/dL, and had diagnosed CVD. Methods Patients were followed through December 2016. Our primary outcomes were a composite of non-fatal MI, non-fatal stroke, unstable angina, coronary revascularization, and all-cause mortality, and a second composite adding peripheral revascularization and aneurysm repair. We compared multivariable adjusted incidence rates and rate ratios (RR) of the outcomes and their components. Results A total of 14,481 patients comprised the normal TG group and 2,702 patients were in the high TG group. Multivariable adjusted incidence of the second composite was 10% greater in the high TG group (50.9/1,000 person-years, 95% CI 47.0-55.2 vs. 46.5, 44.8-48.2, RR 1.10, 95% CI 1.00-1.20, p=0.041). The difference was driven by non-fatal MI (RR 1.20, 95% CI 1.00-1.45, p=0.045), coronary revascularization (RR 1.18, 95% CI 1.00-1.40, p=0.045) and peripheral revascularization (RR 1.56, 95% CI 1.14-2.13, p=0.006). Conclusions CVD risk in statin-treated patients was associated with high TG levels. Ongoing CV outcome trials of add-on therapies in statin treated high-risk patients with high TG levels are testing this hypothesis. Copyright © 2018 Endocrine Society
Journal of Clinical Endocrinology and Metabolism – Oxford University Press
Published: May 29, 2018
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