In patients with established coronary heart disease, severe hypertriglyceridemia (≥500 mg/dL) was associated with a 68% increased risk of 22-year all-cause mortality compared to low-normal levels (P<0.001).
Cohort (n=15,355)
Are elevated triglyceride levels associated with increased all-cause mortality in patients with established coronary heart disease?
Elevated fasting triglyceride levels are independently associated with increased long-term all-cause mortality in patients with established coronary heart disease.
Effect estimate: 68% increased risk
p-value: p=<0.001
BACKGROUND: The independent association between elevated triglycerides and all-cause mortality among patients with established coronary heart disease is controversial. The aim of this study was to investigate this association in a large cohort of patients with proven coronary heart disease. METHODS AND RESULTS: The study cohort comprised 15 355 patients who were screened for the Bezafibrate Infarction Prevention (BIP) trial. Twenty-two-year mortality data were obtained from the national registry. Patients were divided into 5 groups according to strata of fasting serum triglycerides: (1) low-normal triglycerides (<100 mg/dL); (2) high-normal triglycerides (100-149 mg/dL); (3) borderline hypertriglyceridemia triglycerides (150-199 mg/dL); (4) moderate hypertriglyceridemia triglycerides (200-499 mg/dL); (5) severe hypertriglyceridemia triglycerides (≥500 mg/dL). Age- and sex-adjusted survival was 41% in the low-normal triglycerides group than 37%, 36%, 35%, and 25% in groups with progressively higher triglycerides (P<0.001). In an adjusted Cox-regression for various covariates including high-density lipoprotein cholesterol, each 1 unit of natural logarithm (Ln) triglycerides elevation was associated with a corresponding 6% (P=0.016) increased risk of 22-year all-cause mortality. The 22-year mortality risk for patients with severe hypertriglyceridemia was increased by 68% when compared with patients with low-normal triglycerides (P<0.001). CONCLUSIONS: In patients with established coronary heart disease, higher triglycerides levels are independently associated with increased 22-year mortality. Even in patients with triglycerides of 100 to 149 mg/dL, the elevated risk for death could be detected than in patients with lower triglycerides levels, whereas severe hypertriglyceridemia denotes a population with particularly increased mortality risk.
Klempfner et al. (Tue,) conducted a cohort in established coronary heart disease (n=15,355). Elevated fasting serum triglycerides vs. Low-normal triglycerides (<100 mg/dL) was evaluated on 22-year all-cause mortality (68% increased risk, p=<0.001). In patients with established coronary heart disease, severe hypertriglyceridemia (≥500 mg/dL) was associated with a 68% increased risk of 22-year all-cause mortality compared to low-normal levels (P<0.001).