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Increased residual cardiovascular risk in patients with diabetes and high vs normal triglycerides despite statin-controlled LDL cholesterol

Diabetes, Obesity and Metabolism Sep 23, 2018

Nichols GA, et al. – Researchers examined whether high triglyceride (TG) levels in the presence of statin-controlled low-density lipoprotein cholesterol (LDL-C) levels affect the risk of cardiovascular disease (CVD) among individuals with diabetes in real-world clinical practice. They identified adults with diabetes from the Southern California and Northwest regions of Kaiser Permanente, and included those on statin therapy with LDL-C levels from 40 to 100 mg/dL who were not on other lipid-lowering therapies and had a prior diagnosis of atherosclerotic CVD or at least one other CVD risk factor in this analysis. Participants were grouped according to high (n=5,542; 200-499 mg/dL) or normal (n=22,411; < 150 mg/dL) TG levels to compare incidence rates and rate ratios of first non-fatal myocardial infarction, non-fatal stroke, unstable angina, and coronary revascularization. Results showed that cardiovascular events were greater among individuals with diabetes and highly elevated TG levels regardless of statin-controlled LDL-C levels. Given that the researchers controlled for cardiometabolic risk factors, it is probable that the differences in TG levels contributed to the excess risk observed in participants with high TG levels.

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