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.

Description

The ability to use in-trial triglyceride (TG) measurements to predict cardiovascular events (CVEs) was examined using data from the Incremental Decrease in End Points through Aggressive Lipid Lowering (IDEAL) (simvastatin 20 to 40 mg/day) and Treating to New Targets (TNT) (atorvastatin 10 mg/day) trials. The outcome was CVE occurring after the first year of the trial in this large sample of patients with clinical signs of coronary heart disease or with a history of myocardial infraction. After adjustments for age and gender, risk of CVEs increased across quintiles of rising TGs (p<0.001). Thus, patients in the fifth quintiles of TG had a 63% (hazard ratio 1.63, 95% confidence interval 1.46 to 1.81) higher rate of CVE than patients in the lowest quintiles. When adjusted for HDL cholesterol and apoB/apoA1, this association was attenuated and eventually eliminated by adjustment for additional variables. Thus, higher plasma TGs levels are predictive of a residual increase in CVE risk among statin-treated patients.