Higher LDL triglycerides up atherosclerotic CVD risk

Elevated low-density lipoprotein (LDL) triglycerides appear to increase the risk of atherosclerotic cardiovascular disease (ASCVD) and of each ASCVD component, according to a study.

A team of investigators examined the results of the Copenhagen General Population Study, which measured LDL triglycerides in 38,081 individuals with a direct automated assay (direct LDL triglycerides) and in 30,208 individuals with nuclear magnetic resonance (NMR) spectroscopy (NMR LDL triglycerides). Meta-analyses were performed to pool the present findings with previously reported results.

A total of 872 and 5,766 individuals in the two cohorts had a diagnosis of ASCVD during a median follow-up of 3.0 and 9.2 years, respectively.

Hazard ratios (HR) for every 0.1-mmol/L (9 mg/dL) higher direct LDL triglycerides were 1.26 (95 percent confidence interval [CI], 1.17‒1.35) for ASCVD, 1.27 (95 percent CI, 1.16‒1.39) for ischaemic heart disease (IHD), 1.28 (95 percent CI, 1.11‒1.48) for myocardial infarction (MI), 1.22 (95 percent CI, 1.08‒1.38) for ischaemic stroke (IS), and 1.38 (95 percent CI, 1.21‒1.58) for peripheral artery disease (PAD).

For NMR LDL triglycerides, the corresponding HRs were 1.26 (95 percent CI, 1.20‒1.33), 1.33 (95 percent CI, 1.25‒1.41), 1.41 (95 percent CI, 1.31‒1.52), 1.13 (95 percent CI, 1.05‒1.23), and 1.26 (95 percent CI, 1.10‒1.43). Of note, these results were not fully explained statistically by apolipoprotein B levels.

Meta-analyses for the highest versus the lowest quartile of LDL triglycerides revealed the following random-effects risk ratios: 1.50 (95 percent CI, 1.35‒1.66) for ASCVD (four studies: 71,526 individuals; 8,576 events), 1.62 (95 percent CI, 1.37‒1.93) for IHD (six studies: 107,538 individuals; 9,734 events), 1.30 (95 percent CI, 1.13‒1.49) for IS (four studies: 78,026 individuals; 4,273 events), and 1.53 (95 percent CI, 1.29‒1.81) for PAD (four studies: 107,511 individuals; 1,848 events).