Fasting and Non-Fasting Triglycerides and Risk of Cardiovascular Events in Diabetic Patients Under Statin Therapy

• Published in: Circulation Journal 2020/02/25, Vol.84(3), pp.509-515
• Main Authors: Tada, Hayato, Nomura, Akihiro, Yoshimura, Kenichi, Itoh, Hiroshi, Komuro, Issei, Yamagishi, Masakazu, Takamura, Masayuki, Kawashiri, Masa-aki
• Format: Article
• Language: English
• Subjects: Aged; Biomarkers - blood; Cardiovascular disease; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - mortality; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Diabetes Mellitus - mortality; Dyslipidemias - blood; Dyslipidemias - diagnosis; Dyslipidemias - drug therapy; Dyslipidemias - mortality; Fasting - blood; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Incidence; Japan - epidemiology; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Residual risk; Risk Assessment; Risk Factors; Statins; Time Factors; Treatment Outcome; Triglycerides; Triglycerides - blood
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-19-0981

Background:Few data specifically investigate associations between fasting/non-fasting triglycerides (TG) and cardiovascular (CV) events under statin therapy among Japanese diabetic patients.Methods and Results:We recruited 4,988 participants with diabetes from the EMPATHY study. Median follow-up was 3 years. We evaluated associations between serum fasting/non-fasting TG and first CV events in Cox-regression hazard models adjusted by classical risk factors. CV events were defined as (1) major adverse cardiac events (MACE) including myocardial infarction, stroke, or cardiac death; and (2) CV diseases (CVD) including myocardial infarction, unstable angina, ischemic stroke, or large artery disease or peripheral arterial disease. Fasting as well as non-fasting TG were associated with MACE (adjusted hazard ratio [HR]: 1.017 per 10 mg/dL; 95% confidence interval [CI]: 1.000–1.037; P=0.046, adjusted HR: 1.028 per 10 mg/dL; 95% CI: 1.006–1.050; P=0.0091) and CVD (adjusted HR: 1.024 per 10 mg/dL; 95% CI: 1.011–1.038; P=4.4×10−3, adjusted HR: 1.028 per 10 mg/dL; 95% CI: 1.010–1.046; P=4.9×10−3). Comparing the top quartile with the bottom quartile of non-fasting TG, adjusted HR significantly increased 5.18 (95% CI: 1.38–18.3, P=0.014) for MACE, and 2.40 (95% CI: 1.11–4.75, P=0.021) for CVD, while adjusted HR did not change when divided into quartile of fasting TG.Conclusions:Non-fasting TG could be considered as a substitute for fasting TG as a risk stratification for future CV events among Japanese diabetic patients.