Key result
Hypertriglyceridemia linked to ~363% higher MACE risk in high-risk patients with elevated hsCRP.
Why the study?
Data on the prognostic role of hypertriglyceridemia dependent on the state of systemic low-grade inflammation are limited.
Does mild-to-moderate hypertriglyceridemia increase the risk of adverse cardiovascular events in patients at high and very high cardiovascular risk, depending on hsCRP levels?
Cohort (n=185)
Does mild-to-moderate hypertriglyceridemia increase the risk of adverse cardiovascular events in patients at high and very high cardiovascular risk, depending on hsCRP levels?
Relative Risk: 1.61 (95% CI 0.86–3)
p-value: p=0.133
Mild-to-moderate hypertriglyceridemia is a significant predictor of adverse cardiovascular events in high-risk patients only when accompanied by systemic low-grade inflammation (hsCRP ≥2.0 mg/L).
BACKGROUND: It has been established that an increase in triglyceride-rich lipoprotein levels is associated with the development of systemic low-grade inflammation. Data on the prognostic role of hypertriglyceridemia (HTG) dependent on the state of low-grade inflammation are limited. OBJECTIVE: The study's objective was to evaluate the predictive value of mild-to-moderate HTG (2.3- 11.2 mmol/L) regarding the development of cardiovascular events in patients at high and very high cardiovascular risk (CVR), depending on the high-sensitivity C-reactive protein (hsCRP) values. METHODS: The study included 185 patients with high and very high CVR. The concentration of hsCRP in blood serum was measured using an enzyme-linked immunosorbent assay kit. The combined endpoint was cardiovascular death, nonfatal myocardial infarction or unstable angina (which required hospitalization), nonfatal stroke, and coronary revascularization. RESULTS: HTG was revealed in 17.3% of the patients. An increase in hsCRP ≥2.0 mg/L was observed in 51.9% of the patients. The event-free survival of patients with HTG was not statistically different from that in patients with TG <2.3 mmol/L (RR 1.61; 95% CI 0.86-3.00; p=0.133). In the subgroup of patients with hsCRP <2.0 mg/L, patients with HTG were not significantly different from patients without HTG. In the subgroup of patients with hsCRP≥2.0 mg/L, the presence of HTG was associated with a 4.63 times increase in the RR of adverse cardiovascular events (95% CI 1.35-15.8; p=0.015) after adjusting for potential confounders. CONCLUSION: In patients with high and very high CVR, an increase in TG ≥2.3 mmol/L was associated with the development of adverse cardiovascular events only in the subgroup of patients with an increase in hsCRP ≥2.0 mg/L. The presence of HTG was associated with a 4.63 times increase in RR of adverse cardiovascular events (95% CI 1.35-15.8; p=0.015).
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Genkel et al. (2022) conducted a cohort in High and very high cardiovascular risk (n=185). Hypertriglyceridemia (TG 2.3-11.2 mmol/L) vs. Triglycerides <2.3 mmol/L was evaluated on Cardiovascular death, nonfatal myocardial infarction or unstable angina requiring hospitalization, nonfatal stroke, and coronary revascularization (RR 1.61, 95% CI 0.86-3.00, p=0.133). In patients with high cardiovascular risk and hsCRP ≥2.0 mg/L, hypertriglyceridemia was associated with an increased risk of adverse cardiovascular events (RR 4.63; 95% CI 1.35-15.8; p=0.015).
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