Severe and extreme hypertriglyceridemia significantly increased the risk of acute pancreatitis (HR 2.586 and 4.695) and cardiovascular events (HR 1.163 and 1.206) compared to normal triglycerides.
Cohort (n=134,116)
Does severe or extreme hypertriglyceridemia increase the risk of acute pancreatitis and cardiovascular events in adults compared to normal triglyceride levels?
Severe and extreme hypertriglyceridemia are associated with a stepwise increased risk of acute pancreatitis and cardiovascular events compared to normal triglyceride levels.
Effect estimate: HR 2.586 (sHTG) and 4.695 (eHTG) for AP
p-value: p=<0.001
Background: Severe hypertriglyceridemia (sHTG) has a causal role in acute pancreatitis (AP), whereas the relationship between triglyceride (TG) levels and risk of cardiovascular (CV) events is less well-known.Objective: To assess the incidence, risk, and odds of AP and CV events among US adults with sHTG and hypertriglyceridemia (HTG) compared to those with normal TG levels. Methods:The Optum Research Database identified four cohorts of adults with a TG test between 1/1/2017-3/31/2021.sHTG (500 TG < 880 mg/dL) and extreme HTG (eHTG; TG 880 mg/dL) were identified first, followed by random identification of normal TG (35 TG < 150 mg/dL) and HTG (150 TG < 500 mg/dL) cohorts.Primary outcomes included incidence, adjusted risk, and adjusted odds of AP and CV events.Results: 134,116 patients were included: 46,676 (34.8%) with normal TG, 54,090 (40.3%) with HTG, 28,556 (21.3%) with sHTG, and 4994 (3.7%) with eHTG.Incidences of both outcomes were significantly higher for HTG, sHTG, and eHTG, compared with normal TG (p < 0.001).Adjusted hazard ratios (HRs) of AP were 1.491, 2.586, and 4.695 for HTG, J o u r n a l P r e -p r o o f sHTG, and eHTG, respectively (all p < 0.001).Adjusted HRs of CV events were 1.163 and 1.206 for sHTG and eHTG, respectively (both p < 0.001). Conclusion:In this cohort study, patients with sHTG and eHTG had significantly higher incidence of AP and CV events, compared with normal TG.The adjusted risk of AP and CV events increased stepwise with TG level; the association was stronger for AP. Graphical abstractSignificantly higher cumulative incidence of acute pancreatitis (AP) and cardiovascular (CV) events was observed across cohorts of increasing serum/plasma triglyceride (TG) levels.
Kessler et al. (Wed,) conducted a cohort in Severe or extreme hypertriglyceridemia (n=134,116). Severe and extreme hypertriglyceridemia vs. Normal triglyceride levels was evaluated on Incidence, adjusted risk, and adjusted odds of acute pancreatitis and cardiovascular events (HR 2.586 (sHTG) and 4.695 (eHTG) for AP, p=<0.001). Severe and extreme hypertriglyceridemia significantly increased the risk of acute pancreatitis (HR 2.586 and 4.695) and cardiovascular events (HR 1.163 and 1.206) compared to normal triglycerides.