Triglycerides and Residual Atherosclerotic Risk

医学 内科学 优势比 亚临床感染 置信区间 前瞻性队列研究 心脏病学 胃肠病学 炎症 钙化
作者
Sergio Raposeiras‐Roubín,Xavier Rosselló,Belén Oliva,Leticia Fernández‐Friera,José M. Mendiguren,Vicente Andrés,Héctor Bueno,Javier Sanz,Vicente Martínez de Vega,Emad Abu-Assi,Andrés Íñiguez,Antonio Fernández-Ortı́z,Borja Ibáñez,Valentı́n Fuster
出处
期刊:Journal of the American College of Cardiology [Elsevier BV]
卷期号:77 (24): 3031-3041 被引量:160
标识
DOI:10.1016/j.jacc.2021.04.059
摘要

Even when low-density lipoprotein-cholesterol (LDL-C) levels are lower than guideline thresholds, a residual risk of atherosclerosis remains. It is unknown whether triglyceride (TG) levels are associated with subclinical atherosclerosis and vascular inflammation regardless of LDL-C. This study sought to assess the association between serum TG levels and early atherosclerosis and vascular inflammation in apparently healthy individuals. An observational, longitudinal, and prospective cohort study, including 3,754 middle-aged individuals with low to moderate cardiovascular risk from the PESA (Progression of Early Subclinical Atherosclerosis) study who were consecutively recruited between June 2010 and February 2014, was conducted. Peripheral atherosclerotic plaques were assessed by 2-dimensional vascular ultrasound, and coronary artery calcification (CAC) was assessed by noncontrast computed tomography, whereas vascular inflammation was assessed by fluorine-18 fluorodeoxyglucose uptake on positron emission tomography. Atherosclerotic plaques and CAC were observed in 58.0% and 16.8% of participants, respectively, whereas vascular inflammation was evident in 46.7% of evaluated participants. After multivariate adjustment, TG levels ≥150 mg/dl showed an association with subclinical noncoronary atherosclerosis (odds ratio [OR]: 1.35; 95% confidence interval [CI]: 1.08 to 1.68; p = 0.008). This association was significant for groups with high LDL-C (OR: 1.42; 95% CI: 1.11 to 1.80; p = 0.005) and normal LDL-C (OR: 1.85; 95% CI: 1.08 to 3.18; p = 0.008). No association was found between TG level and CAC score. TG levels ≥150 mg/dl were significantly associated with the presence of arterial inflammation (OR: 2.09; 95% CI: 1.29 to 3.40; p = 0.003). In individuals with low to moderate cardiovascular risk, hypertriglyceridemia was associated with subclinical atherosclerosis and vascular inflammation, even in participants with normal LDL-C levels. (Progression of Early Subclinical Atherosclerosis [PESA]; NCT01410318)
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