1. Long-term prognostic utility of low-density lipoprotein (LDL) triglyceride in real-world patients with coronary artery disease and diabetes or prediabetes
- Author
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Raul D. Santos, Ying Gao, Cheng-Gang Zhu, Qi Hua, Hui-Wen Zhang, Xiao-Lin Li, Yan-Fang Li, Chuan-Jue Cui, Rui-Xia Xu, Jing-Lu Jin, Hui-Hui Liu, Qian Dong, Jing Sun, Ye-Xuan Cao, Geng Liu, Jian-Jun Li, Yuan-Lin Guo, Na-Qiong Wu, and Yan Zhang
- Subjects
Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Endocrinology, Diabetes and Metabolism ,Myocardial Infarction ,Coronary Artery Disease ,Coronary artery disease ,chemistry.chemical_compound ,Interquartile range ,Prediabetes ,Coronary Artery Bypass ,Prospective cohort study ,Original Investigation ,Hazard ratio ,Diabetes ,Middle Aged ,Prognosis ,Hospitalization ,Lipoproteins, LDL ,Cardiovascular Diseases ,Cardiology ,Female ,Pre-diabetes ,Cardiology and Cardiovascular Medicine ,LDL-TG ,medicine.medical_specialty ,Stable CAD ,Prediabetic State ,Percutaneous Coronary Intervention ,Internal medicine ,Diabetes mellitus ,medicine ,Diabetes Mellitus ,Humans ,Angina, Unstable ,MACEs ,Triglycerides ,Aged ,Glycated Hemoglobin ,Triglyceride ,business.industry ,Cholesterol, HDL ,Cholesterol, LDL ,medicine.disease ,Confidence interval ,chemistry ,Diabetes Mellitus, Type 2 ,lcsh:RC666-701 ,Case-Control Studies ,Thrombotic Stroke ,business - Abstract
Background Recent guidelines highlighted the association between atherosclerosis and triglyceride-enriched lipoproteins in patients with impaired glucose metabolism. However, evidence from prospective studies for long-term prognostic utility of low-density lipoprotein triglyceride (LDL-TG) in real-world patients with prediabetes (Pre-DM) or diabetes mellitus (DM) and coronary artery disease (CAD) is currently not available. The aim of the present study was to evaluate the impact of LDL-TG on major adverse cardiovascular events (MACEs) in patients with stable CAD under different glucose metabolism status. Methods A total of 4381 patients with CAD were consecutively enrolled and plasma LDL-TG level was measured by an automated homogeneous assay. They were categorized according to both status of glucose metabolism [DM, Pre-DM, normal glycaemia regulation (NGR)] and tertiles of LDL-TG. All subjects were followed up for the occurrence of MACEs. Results During a median of 5.1 (interquartile range 3.9 to 5.9) years’ follow-up, 507 (11.6%) MACEs occurred. Cubic spline models showed a significant association between LDL-TG and MACEs in DM and Pre-DM but not in NGR. When the combined effect of elevated LDL-TG and glucose disorders was considered for risk stratification, the medium tertile of LDL-TG plus DM, and the highest tertile of LDL-TG plus Pre-DM or plus DM subgroups were associated with significantly higher risk of MACEs after adjustment of confounders including triglyceride [hazard ratios (95% confidence intervals): 1.843 (1.149–2.955), 1.828 (1.165–2.867), 2.212 (1.396–3.507), all p Conclusions In this longitudinal cohort study on real-world practice, higher LDL-TG was associated with worse outcomes among Pre-DM and DM patients with stable CAD.
- Published
- 2020