Risk prediction with triglycerides in patients with stable coronary disease on statin treatment
Abstract
Background The aim of the prospective Homburg Cream and Sugar study was to analyze the role of fasting and postprandial serum triglycerides (TG) as risk modifiers in patients with coronary artery disease (CAD).Methods and results A sequential oral triglyceride and glucose tolerance test was developed to obtain standardized measurements of postprandial TG kinetics and glucose in 514 consecutive patients with stable CAD confirmed by angiography (95% were treated with a statin). Fasting and postprandial TG predicted the primary outcome measure of cardiovascular death and hospitalizations after 48 months follow-up (fasting TG >150 vs. <106 mg/dl: Hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.31-2.45, p = 0.0001; area under the curve >1120 vs. <750 mg/dl/5 hr: HR 1.78, 95% CI 1.29-2.45, p = 0.0003). Parameters of the postprandial TG increase did not improve risk prediction compared to fasting TG. The number of cardiovascular deaths and myocardial infarctions was higher in the upper tertile of fasting TG (HR 1.79, 95%-CI 1.04-3.09, p = 0.03). Risk prediction by TG was independent of traditional risk factors, medication, glucose metabolism, LDL- and HDL-cholesterol. Total cholesterol, LDL- and HDL-cholesterol concentrations were not associated with the primary outcome.Conclusions Fasting serum triglycerides >150 mg/dl independently predict cardiovascular events in patients with coronary artery disease on guideline-recommended medication. Assessment of postprandial TG does not improve risk prediction compared to fasting TG in these patients.
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An oral fat tolerance test did not improve risk prediction in patients with coronary artery disease compared with fasting TG, and post-prandial TG increase is highly correlated with fasting TG concentrations.
“However, an oral fat tolerance test to assess post-prandial TG kinetics did not improve risk prediction in patients with coronary artery disease compared with fasting TG; indeed post-prandial TG increase is highly correlated with fasting TG concentrations.37”
From Clinical review on triglycerides (2020) · cites this paper as [37]
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- Authors
- Werner, C., Filmer, A., Fritsch, M., Groenewold, S., Gräber, S., Böhm, M., & Laufs, U.
- Affiliations
- Universitätsklinikum des Saarlandes (DE)
- Corresponding author
- Werner, Christian
- Venue
- Clinical Research in Cardiology
- Published
- 2014-07-11
- Volume
- 103
- Issue
- 12
- Pages
- 984-997
- ISSN
- 1861-0684 (ISSN-L)
- 1861-0692
- OpenAlex
- W2170875544
- Cited by
- 13
- References
- 61
- Citations by year
- 2024: 1 · 2022: 2 · 2020: 4 · 2019: 1 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 2
- FWCI
- 1.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Clinical Research in Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Deutsche Stiftung für Herzforschung
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Keywords
- serum triglycerides, fasting triglycerides, postprandial triglycerides, coronary artery disease, stable coronary artery disease, statin therapy, cardiovascular risk prediction, cardiovascular mortality, myocardial infarction, triglyceride kinetics
- MeSH terms
- Adult, Aged, Aged, 80 and over, Blood Glucose, Coronary Artery Disease, Electrocardiography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Severity of Illness Index, Triglycerides, Biomarkers, Coronary Angiography, Disease Progression, Risk Assessment, Hydroxymethylglutaryl-CoA Reductase Inhibitors
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