Plasma Triglycerides and Cardiovascular Events in the Treating to New Targets and Incremental Decrease in End-Points Through Aggressive Lipid Lowering Trials of Statins in Patients With Coronary Artery Disease

Færgeman, Ole; Holme, Ingar; Fayyad, Rana; Bhatia, Sonal; Grundy, Scott M.; Kastelein, John J.P.; LaRosa, John C.; Larsen, Mogens Lytken; Lindahl, Christina; Olsson, Anders; Tikkanen, Matti J.; Waters, David D.; Pedersen, Terje R.

doi:10.1016/j.amjcard.2009.04.008

Cited by 142 publications

(85 citation statements)

References 20 publications

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“…The current study expands on previous findings which have demonstrated an inverse association between HDL-C and risk of cardiovascular morbidities and mortality [10,11,13,14,[16][17][18]. While confirming clinical trial based findings [19,23], this retrospective observational study of UK primary care practices demonstrated increases in HDL-C to be associated with decreased risk of subsequent acute cardiovascular events among patients on statins.…”

Section: Discussionsupporting

confidence: 60%

“…Both US and European recommendations focus on low-density lipoprotein cholesterol (LDL-C) to lower cardiovascular risk [7,8]. However, both elevated triglycerides [9,10], and low high-density lipoprotein cholesterol (HDL-C) [11,12] have been identified as cardiovascular risk factors and have been shown to be associated with coronary events, even among patients treated with statins [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association between change in HDL-C and vascular events in patients treated with statins: Report from the UK general practice research database

Bash¹,

Hsu²,

Sazonov³

et al. 2012

WJCD

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Dyslipidemia, including low levels of high-density lipoprotein cholesterol (HDL-C), is a relatively wellestablished risk factor for cardiovascular disease. However, the independent association between changes in HDL-C and the subsequent risk of cardiovascular events has not been well studied. The retrospective cohort analysis was conducted to evaluate the association between changes in HDL-C and cardiovascular (

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Section: Discussionsupporting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Association between change in HDL-C and vascular events in patients treated with statins: Report from the UK general practice research database

Bash¹,

Hsu²,

Sazonov³

et al. 2012

WJCD

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“…In a separate analysis of the Optum Research Database of 4 867 300 patients with at least 1 prescription fill for a statin, 1 418 866 had at least 1 LDL‐C measurement ≤2.59 mmol/L (≤100 mg/dL); of these patients, 693 308 (48.9%) had at least 1 triglycerides measurement ≥1.69 mmol/L (≥150 mg/dL), and 421 974 (29.7%) had at least 1 triglycerides measurement ≥2.26 mmol/L (≥200 mg/dL). This is supported by large cardiovascular outcomes trials, including or limited to patients with type 2 diabetes mellitus, wherein ≈15% to 20% of patients had triglycerides ≥2.26 mmol/L (≥200 mg/dL) and LDL‐C <2.59 mmol/L (<100 mg/dL) and ≈25% to 40% had triglycerides ≥1.69 mmol/L (≥150 mg/dL) and LDL‐C <2.59 mmol/L (<100 mg/dL) 23, 27, 28, 29, 30, 31, 32. Despite this relatively high prevalence, there is a lack of prospective data designed specifically to investigate such patient populations with high triglycerides despite statin therapy.…”

Section: Discussionmentioning

confidence: 99%

High Triglycerides Are Associated With Increased Cardiovascular Events, Medical Costs, and Resource Use: A Real‐World Administrative Claims Analysis of Statin‐Treated Patients With High Residual Cardiovascular Risk

Tóth

Granowitz

Hüll

et al. 2018

JAHA

122

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BackgroundThe American Heart Association recognizes high triglycerides as a cardiovascular risk factor.Methods and ResultsThis retrospective observational administrative claims analysis (Optum Research Database) included statin‐treated patients ≥45 years old with diabetes mellitus and/or atherosclerotic cardiovascular disease, triglycerides 2.26 to 5.64 mmol/L, and a propensity‐matched comparator cohort with triglycerides <1.69 mmol/L and high‐density lipoprotein cholesterol >1.04 mmol/L. In the high‐triglycerides cohort versus comparators (both n=10 990, 49% women), mean age was 61.7 versus 62.2 years and follow‐up was 41.3 versus 42.1 months, respectively. Multivariate analysis of composite major cardiovascular events demonstrated significantly increased risk in the high‐triglycerides (n=13 411 patients) versus comparator (n=32 506 patients) cohorts (hazard ratio [HR], 1.35; 95% confidence interval [CI], 1.225–1.485; P<0.001), with significantly higher risk for nonfatal myocardial infarction (HR, 1.35; 95% CI, 1.19–1.52; P<0.001), nonfatal stroke (HR, 1.27; 95% CI, 1.14–1.42; P<0.001), and need for coronary revascularization (HR, 1.51; 95% CI, 1.34–1.69; P<0.001), but not unstable angina or cardiovascular death. Increased cardiovascular risk in the high‐triglycerides versus comparator cohort was maintained, even with addition of non–high‐density lipoprotein cholesterol to the multivariate model and when analyzing high and low high‐density lipoprotein cholesterol subgroups. Average total healthcare cost per patient per month (cost ratio, 1.15; 95% CI, 1.084–1.210; P<0.001) and rate of occurrence of inpatient hospital stay (HR, 1.17; 95% CI, 1.113–1.223; P<0.001) were also significantly greater in the high‐triglycerides cohort.ConclusionsIn this real‐world analysis, patients with high cardiovascular risk and high triglycerides had worse composite cardiovascular and health economic outcomes than patients with well‐managed triglycerides and high‐density lipoprotein cholesterol >1.04 mmol/L.

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“…25,[27][28][29][30][31][32][33][34] Thus, the analyses presented are limited to C-reactive protein (CRP), hemoglobin A1C (hgA1C), and high-density lipoprotein (HDL) cholesterol.…”

Section: Blood Specimen Collection and Assaysmentioning

confidence: 99%

Neighborhood Socioeconomic Status in Relation to Serum Biomarkers in the Black Women’s Health Study

et al. 2016

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Lower neighborhood socioeconomic status (SES) is associated with higher cardiovascular disease (CVD) risk. Black women have a higher CVD risk and are more likely to live in poor neighborhoods than white women. We examined the association of neighborhood SES with several CVD biomarkers using data from the Black Women's Health Study (BWHS), a follow-up study of US black women reporting high levels of education and income. Blood specimens of 418 BWHS participants were assayed for Creactive protein (CRP), hemoglobin A1C (hgA1C), and high-density lipoprotein (HDL) cholesterol. US Census block group data were linked to the women's addresses to reflect neighborhood SES. Multivariable-adjusted mixed linear regression models that adjusted for person-level SES and for cardiovascular risk factors were used to assess CRP, hgA1C, and HDL levels in relation to quintiles of neighborhood SES. Women living in the poorest neighborhoods had the least favorable biomarker levels. As neighborhood SES increased, CRP decreased (P for trend = 0.01), hgA1C decreased (P for trend = 0.07), and HDL increased (P for trend = 0.19). These associations were present within strata of individual educational level. The present findings suggest that neighborhood environments may affect physiological processes within residents independently of individual SES.

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Plasma Triglycerides and Cardiovascular Events in the Treating to New Targets and Incremental Decrease in End-Points Through Aggressive Lipid Lowering Trials of Statins in Patients With Coronary Artery Disease

Cited by 142 publications

References 20 publications

Association between change in HDL-C and vascular events in patients treated with statins: Report from the UK general practice research database

Association between change in HDL-C and vascular events in patients treated with statins: Report from the UK general practice research database

High Triglycerides Are Associated With Increased Cardiovascular Events, Medical Costs, and Resource Use: A Real‐World Administrative Claims Analysis of Statin‐Treated Patients With High Residual Cardiovascular Risk

Neighborhood Socioeconomic Status in Relation to Serum Biomarkers in the Black Women’s Health Study

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