Elevated Triglyceride Level Is Independently Associated with Increased All-Cause Mortality in Patients with Established Coronary Heart Disease: Twenty-Two-Year Follow-Up of the Bezafibrate Infarction Prevention Study and Registry

Robert Klempfner, Aharon Erez*, Ben Zekry Sagit, Ilan Goldenberg, Enrique Fisman, Eran Kopel, Nir Shlomo, Ariel Israel, Alexander Tenenbaum

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)100-108
Number of pages9
JournalCirculation: Cardiovascular Quality and Outcomes
Volume9
Issue number2
DOIs
StatePublished - 1 Mar 2016

Keywords

  • cholesterol HDL
  • coronary disease
  • hypertriglyceridemia
  • mortality
  • triglycerides

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