Author + information
- Ann Marie Navar,
- Neha Pagidipati,
- Hillary Mulder,
- Tsion Aberra,
- Sephy Philip,
- Craig Granowitz and
- Eric Peterson
High triglycerides (TG) have been shown to be a risk factor for coronary heart disease (CHD). Measured TG levels vary considerably and it is unclear how best to assess TG-associated risk.
We evaluated the association between TG and CHD events (myocardial infarction, angina, revascularization, and CV death) in adults in the Framingham Offspring Study free of CVD by age 55 (age range 53-57). The strength association between various measures of TG (including baseline, average TG across all exams, maximum TG, area under the curve of TG, standard deviation of TG levels, and coefficient of variation of TG over time) and subsequent CHD events was determined using a Cox proportional hazards model.
1336 adults free of CHD were identified (53% female, median age 55, 5.4% diabetes), in whom the 10-year CHD Kaplan-Meier event rate was 6.9%. Among the various TG measures, average TG over prior years was most strongly related to CHD events (C-index 0.67), followed by maximum TG level (C-index 0.65), area under the curve (0.64), triglycerides at exam 1 (0.64), and triglycerides at baseline (0.63). The association between average TG and future CHD risk was nonlinear (p<0.0001). CVD risk increased with increasing TG to a level of 150 mg/dL (HR 1.19 per 10 mg/dL increase, 95% CI 1.13 - 1.26) above which the association was flat (figure).
Average TG are more correlated with CHD risk than a single point-in-time TG level. Even with TGs below 150 mg/dL, CHD risk rises rapidly with increasing TGs.
Poster Hall, Hall F
Monday, March 18, 2019, 9:45 a.m.-10:30 a.m.
Session Title: Prevention: Clinical 5
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1331-414
- 2019 American College of Cardiology Foundation