Serum triglycerides predict first cardiovascular events in diabetic patients with hypercholesterolemia and retinopathy

Hayato Tada, Masa Aki Kawashiri, Akihiro Nomura, Kenichi Yoshimura, Hiroshi Itoh, Issei Komuro, Masakazu Yamagishi

研究成果: Article

7 引用 (Scopus)

抄録

Aims: Low-density lipoprotein cholesterol predicts cardiovascular events in patients with diabetes. However, it is uncertain whether serum triglycerides level is also associated with an occurrence of future cardiovascular events in diabetic patients. We aimed to test whether serum triglycerides is associated with first cardiovascular events in diabetic patients. Methods and results: We recruited 5042 participants with diabetes mellitus from the standard versus intEnsive statin therapy for hypercholesteroleMic Patients with diAbetic retinopaTHY (EMPATHY), multicenter, prospective, randomized, open-label, blinded-endpoint study. Median follow-up was three years. We evaluated an association of serum triglycerides with first cardiovascular events in cox-regression hazard models adjusted by age, sex, hypertension, current smoking, low-density lipoprotein cholesterol, and body mass index. Cardiovascular events were defined as (a) major adverse cardiac events including myocardial infarction, stroke, or cardiac death; and (b) cardiovascular diseases including myocardial infarction, unstable angina, ischemic stroke, or large artery disease or peripheral arterial disease. Serum triglycerides were associated with major adverse cardiac events (adjusted hazard ratio: 1.021 per 10 mg/dl; 95% confidence interval: 1.007–1.035; p = 0.0025) and cardiovascular diseases (adjusted hazard ratio: 1.023 per 10 mg/dl; 95% confidence interval: 1.013–1.034; p = 0.0000077). Comparing the top quintile (>185 mg/dl) with the bottom quintile (<79 mg/dl), the adjusted hazard ratio increased 1.89 (95% confidence interval: 1.03–2.80, p = 0.04) for major adverse cardiac events, and 1.90 (95% confidence interval: 1.18–3.07, p = 0.007) for cardiovascular diseases. There were no overall interactions of triglycerides and treatment assignment (standard/intensive statins) on both outcomes (p-trend = 0.33 for major adverse cardiac events, p-trend = 0.62 for cardiovascular diseases). Conclusions: Serum triglycerides were associated with first cardiovascular events among high-risk diabetes patients with hypercholesterolemia and retinopathy.

元の言語English
ジャーナルEuropean Journal of Preventive Cardiology
DOI
出版物ステータスAccepted/In press - 2018 1 1

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Hypercholesterolemia
Triglycerides
Cardiovascular Diseases
Serum
Confidence Intervals
Hydroxymethylglutaryl-CoA Reductase Inhibitors
LDL Cholesterol
Stroke
Myocardial Infarction
Peripheral Arterial Disease
Unstable Angina
Diabetic Retinopathy
Proportional Hazards Models
Diabetes Mellitus
Body Mass Index
Arteries
Smoking
Hypertension
Therapeutics

ASJC Scopus subject areas

  • Epidemiology
  • Cardiology and Cardiovascular Medicine

これを引用

Serum triglycerides predict first cardiovascular events in diabetic patients with hypercholesterolemia and retinopathy. / Tada, Hayato; Kawashiri, Masa Aki; Nomura, Akihiro; Yoshimura, Kenichi; Itoh, Hiroshi; Komuro, Issei; Yamagishi, Masakazu.

:: European Journal of Preventive Cardiology, 01.01.2018.

研究成果: Article

Tada, Hayato ; Kawashiri, Masa Aki ; Nomura, Akihiro ; Yoshimura, Kenichi ; Itoh, Hiroshi ; Komuro, Issei ; Yamagishi, Masakazu. / Serum triglycerides predict first cardiovascular events in diabetic patients with hypercholesterolemia and retinopathy. :: European Journal of Preventive Cardiology. 2018.
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title = "Serum triglycerides predict first cardiovascular events in diabetic patients with hypercholesterolemia and retinopathy",
abstract = "Aims: Low-density lipoprotein cholesterol predicts cardiovascular events in patients with diabetes. However, it is uncertain whether serum triglycerides level is also associated with an occurrence of future cardiovascular events in diabetic patients. We aimed to test whether serum triglycerides is associated with first cardiovascular events in diabetic patients. Methods and results: We recruited 5042 participants with diabetes mellitus from the standard versus intEnsive statin therapy for hypercholesteroleMic Patients with diAbetic retinopaTHY (EMPATHY), multicenter, prospective, randomized, open-label, blinded-endpoint study. Median follow-up was three years. We evaluated an association of serum triglycerides with first cardiovascular events in cox-regression hazard models adjusted by age, sex, hypertension, current smoking, low-density lipoprotein cholesterol, and body mass index. Cardiovascular events were defined as (a) major adverse cardiac events including myocardial infarction, stroke, or cardiac death; and (b) cardiovascular diseases including myocardial infarction, unstable angina, ischemic stroke, or large artery disease or peripheral arterial disease. Serum triglycerides were associated with major adverse cardiac events (adjusted hazard ratio: 1.021 per 10 mg/dl; 95{\%} confidence interval: 1.007–1.035; p = 0.0025) and cardiovascular diseases (adjusted hazard ratio: 1.023 per 10 mg/dl; 95{\%} confidence interval: 1.013–1.034; p = 0.0000077). Comparing the top quintile (>185 mg/dl) with the bottom quintile (<79 mg/dl), the adjusted hazard ratio increased 1.89 (95{\%} confidence interval: 1.03–2.80, p = 0.04) for major adverse cardiac events, and 1.90 (95{\%} confidence interval: 1.18–3.07, p = 0.007) for cardiovascular diseases. There were no overall interactions of triglycerides and treatment assignment (standard/intensive statins) on both outcomes (p-trend = 0.33 for major adverse cardiac events, p-trend = 0.62 for cardiovascular diseases). Conclusions: Serum triglycerides were associated with first cardiovascular events among high-risk diabetes patients with hypercholesterolemia and retinopathy.",
keywords = "cardiovascular disease, residual risk, statin, Triglycerides",
author = "Hayato Tada and Kawashiri, {Masa Aki} and Akihiro Nomura and Kenichi Yoshimura and Hiroshi Itoh and Issei Komuro and Masakazu Yamagishi",
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T1 - Serum triglycerides predict first cardiovascular events in diabetic patients with hypercholesterolemia and retinopathy

AU - Tada, Hayato

AU - Kawashiri, Masa Aki

AU - Nomura, Akihiro

AU - Yoshimura, Kenichi

AU - Itoh, Hiroshi

AU - Komuro, Issei

AU - Yamagishi, Masakazu

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Aims: Low-density lipoprotein cholesterol predicts cardiovascular events in patients with diabetes. However, it is uncertain whether serum triglycerides level is also associated with an occurrence of future cardiovascular events in diabetic patients. We aimed to test whether serum triglycerides is associated with first cardiovascular events in diabetic patients. Methods and results: We recruited 5042 participants with diabetes mellitus from the standard versus intEnsive statin therapy for hypercholesteroleMic Patients with diAbetic retinopaTHY (EMPATHY), multicenter, prospective, randomized, open-label, blinded-endpoint study. Median follow-up was three years. We evaluated an association of serum triglycerides with first cardiovascular events in cox-regression hazard models adjusted by age, sex, hypertension, current smoking, low-density lipoprotein cholesterol, and body mass index. Cardiovascular events were defined as (a) major adverse cardiac events including myocardial infarction, stroke, or cardiac death; and (b) cardiovascular diseases including myocardial infarction, unstable angina, ischemic stroke, or large artery disease or peripheral arterial disease. Serum triglycerides were associated with major adverse cardiac events (adjusted hazard ratio: 1.021 per 10 mg/dl; 95% confidence interval: 1.007–1.035; p = 0.0025) and cardiovascular diseases (adjusted hazard ratio: 1.023 per 10 mg/dl; 95% confidence interval: 1.013–1.034; p = 0.0000077). Comparing the top quintile (>185 mg/dl) with the bottom quintile (<79 mg/dl), the adjusted hazard ratio increased 1.89 (95% confidence interval: 1.03–2.80, p = 0.04) for major adverse cardiac events, and 1.90 (95% confidence interval: 1.18–3.07, p = 0.007) for cardiovascular diseases. There were no overall interactions of triglycerides and treatment assignment (standard/intensive statins) on both outcomes (p-trend = 0.33 for major adverse cardiac events, p-trend = 0.62 for cardiovascular diseases). Conclusions: Serum triglycerides were associated with first cardiovascular events among high-risk diabetes patients with hypercholesterolemia and retinopathy.

AB - Aims: Low-density lipoprotein cholesterol predicts cardiovascular events in patients with diabetes. However, it is uncertain whether serum triglycerides level is also associated with an occurrence of future cardiovascular events in diabetic patients. We aimed to test whether serum triglycerides is associated with first cardiovascular events in diabetic patients. Methods and results: We recruited 5042 participants with diabetes mellitus from the standard versus intEnsive statin therapy for hypercholesteroleMic Patients with diAbetic retinopaTHY (EMPATHY), multicenter, prospective, randomized, open-label, blinded-endpoint study. Median follow-up was three years. We evaluated an association of serum triglycerides with first cardiovascular events in cox-regression hazard models adjusted by age, sex, hypertension, current smoking, low-density lipoprotein cholesterol, and body mass index. Cardiovascular events were defined as (a) major adverse cardiac events including myocardial infarction, stroke, or cardiac death; and (b) cardiovascular diseases including myocardial infarction, unstable angina, ischemic stroke, or large artery disease or peripheral arterial disease. Serum triglycerides were associated with major adverse cardiac events (adjusted hazard ratio: 1.021 per 10 mg/dl; 95% confidence interval: 1.007–1.035; p = 0.0025) and cardiovascular diseases (adjusted hazard ratio: 1.023 per 10 mg/dl; 95% confidence interval: 1.013–1.034; p = 0.0000077). Comparing the top quintile (>185 mg/dl) with the bottom quintile (<79 mg/dl), the adjusted hazard ratio increased 1.89 (95% confidence interval: 1.03–2.80, p = 0.04) for major adverse cardiac events, and 1.90 (95% confidence interval: 1.18–3.07, p = 0.007) for cardiovascular diseases. There were no overall interactions of triglycerides and treatment assignment (standard/intensive statins) on both outcomes (p-trend = 0.33 for major adverse cardiac events, p-trend = 0.62 for cardiovascular diseases). Conclusions: Serum triglycerides were associated with first cardiovascular events among high-risk diabetes patients with hypercholesterolemia and retinopathy.

KW - cardiovascular disease

KW - residual risk

KW - statin

KW - Triglycerides

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