Association of Hypertriglyceridemia with All‐Cause Mortality and Atherosclerotic Cardiovascular Events in a Low‐Risk Italian Population: The TG‐REAL Retrospective Cohort Analysis
Background Evidence regarding the relationships among high plasma triglycerides (TG), all‐cause mortality, and atherosclerotic cardiovascular disease (ASCVD) events in low‐to‐moderate risk individuals is limited. The aim of this study was to determine whether the presence of high TG levels influence...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-10-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.015801 |
| _version_ | 1811333988907745280 |
|---|---|
| author | Marcello Arca Chiara Veronesi Laura D’Erasmo Claudio Borghi Furio Colivicchi Gaetano Maria De Ferrari Giovambattista Desideri Roberto Pontremoli Pier Luigi Temporelli Valentina Perrone Luca Degli Esposti |
| author_facet | Marcello Arca Chiara Veronesi Laura D’Erasmo Claudio Borghi Furio Colivicchi Gaetano Maria De Ferrari Giovambattista Desideri Roberto Pontremoli Pier Luigi Temporelli Valentina Perrone Luca Degli Esposti |
| author_sort | Marcello Arca |
| collection | DOAJ |
| description | Background Evidence regarding the relationships among high plasma triglycerides (TG), all‐cause mortality, and atherosclerotic cardiovascular disease (ASCVD) events in low‐to‐moderate risk individuals is limited. The aim of this study was to determine whether the presence of high TG levels influences the risk of all‐cause mortality and ASCVD events in a population cohort followed in the real‐world clinical setting. Methods and Results A retrospective longitudinal cohort analysis using administrative databases of 3 Italian Local Health Units was performed. All individuals with at least one TG measurement between January 1, 2010 and December 31, 2015 were followed through December 2016. Outcome measures included incident ASCVD events and all‐cause mortality. Individuals with normal TG levels (<150 mg/dL) were compared with those with high (150–500 mg/dL) and very high TG (>500 mg/dL). 158 042 individuals (142 289 with normal, 15 558 with high, and 195 with very high TG) were considered. In the whole cohort, the overall incidence rates of ASCVD and all‐cause mortality were 7.2 and 17.1 per 1000 person‐years, respectively. After multivariate adjustment for potential confounders, individuals with high and very high TG showed a significantly increased risk of all‐cause mortality (hazard ratio [HR]=1.49 [95% confidence interval (CI) 1.36–1.63], P<0.001, and HR=3.08 [95% CI 1.46–6.50], P<0.01, respectively) and incident ASCVD events (HR=1.61 [95% CI 1.43–1.82], P<0.001, and HR=2.30 [95% CI 1.02–5.18], P<0.05, respectively) as compared to those with normal TG. Conclusions Moderate‐to‐severe elevation of TG is associated with a significantly increased risk of all‐cause mortality and ASCVD events in a large cohort of low‐to‐moderate cardiovascular risk individuals in a real‐world clinical setting. |
| first_indexed | 2024-04-13T17:01:06Z |
| format | Article |
| id | doaj.art-1962af8dc1fb4f95b239950bab1688f5 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T17:01:06Z |
| publishDate | 2020-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-1962af8dc1fb4f95b239950bab1688f52022-12-22T02:38:38ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-10-0191910.1161/JAHA.119.015801Association of Hypertriglyceridemia with All‐Cause Mortality and Atherosclerotic Cardiovascular Events in a Low‐Risk Italian Population: The TG‐REAL Retrospective Cohort AnalysisMarcello Arca0Chiara Veronesi1Laura D’Erasmo2Claudio Borghi3Furio Colivicchi4Gaetano Maria De Ferrari5Giovambattista Desideri6Roberto Pontremoli7Pier Luigi Temporelli8Valentina Perrone9Luca Degli Esposti10Department of Translational and Precision Medicine Sapienza University of Rome ItalyCliCon Srl, Health Economics and Outcomes Research Ravenna ItalyDepartment of Translational and Precision Medicine Sapienza University of Rome ItalyDepartment of Medical and Surgical Sciences University of Bologna ItalyCardiology Division Emergency Department San Filippo Neri Hospital ASL Roma 1 Rome ItalyDivision of Cardiology Department of Medical Sciences “Città della Salute e della Scienza di Torino” Hospital University of Turin ItalyDepartment of Life, Health, and Environmental Sciences University of L’Aquila ItalyDepartment of Internal Medicine University of Genoa and IRCCS Policlinico San Martino Genoa ItalyDivision of Cardiac Rehabilitation Istituti Clinici Scientifici Maugeri IRCCS Gattico‐Veruno ItalyCliCon Srl, Health Economics and Outcomes Research Ravenna ItalyCliCon Srl, Health Economics and Outcomes Research Ravenna ItalyBackground Evidence regarding the relationships among high plasma triglycerides (TG), all‐cause mortality, and atherosclerotic cardiovascular disease (ASCVD) events in low‐to‐moderate risk individuals is limited. The aim of this study was to determine whether the presence of high TG levels influences the risk of all‐cause mortality and ASCVD events in a population cohort followed in the real‐world clinical setting. Methods and Results A retrospective longitudinal cohort analysis using administrative databases of 3 Italian Local Health Units was performed. All individuals with at least one TG measurement between January 1, 2010 and December 31, 2015 were followed through December 2016. Outcome measures included incident ASCVD events and all‐cause mortality. Individuals with normal TG levels (<150 mg/dL) were compared with those with high (150–500 mg/dL) and very high TG (>500 mg/dL). 158 042 individuals (142 289 with normal, 15 558 with high, and 195 with very high TG) were considered. In the whole cohort, the overall incidence rates of ASCVD and all‐cause mortality were 7.2 and 17.1 per 1000 person‐years, respectively. After multivariate adjustment for potential confounders, individuals with high and very high TG showed a significantly increased risk of all‐cause mortality (hazard ratio [HR]=1.49 [95% confidence interval (CI) 1.36–1.63], P<0.001, and HR=3.08 [95% CI 1.46–6.50], P<0.01, respectively) and incident ASCVD events (HR=1.61 [95% CI 1.43–1.82], P<0.001, and HR=2.30 [95% CI 1.02–5.18], P<0.05, respectively) as compared to those with normal TG. Conclusions Moderate‐to‐severe elevation of TG is associated with a significantly increased risk of all‐cause mortality and ASCVD events in a large cohort of low‐to‐moderate cardiovascular risk individuals in a real‐world clinical setting.https://www.ahajournals.org/doi/10.1161/JAHA.119.015801all‐cause mortalityatherosclerotic cardiovascular diseasehypertriglyceridemiareal‐worldtriglycerides |
| spellingShingle | Marcello Arca Chiara Veronesi Laura D’Erasmo Claudio Borghi Furio Colivicchi Gaetano Maria De Ferrari Giovambattista Desideri Roberto Pontremoli Pier Luigi Temporelli Valentina Perrone Luca Degli Esposti Association of Hypertriglyceridemia with All‐Cause Mortality and Atherosclerotic Cardiovascular Events in a Low‐Risk Italian Population: The TG‐REAL Retrospective Cohort Analysis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease all‐cause mortality atherosclerotic cardiovascular disease hypertriglyceridemia real‐world triglycerides |
| title | Association of Hypertriglyceridemia with All‐Cause Mortality and Atherosclerotic Cardiovascular Events in a Low‐Risk Italian Population: The TG‐REAL Retrospective Cohort Analysis |
| title_full | Association of Hypertriglyceridemia with All‐Cause Mortality and Atherosclerotic Cardiovascular Events in a Low‐Risk Italian Population: The TG‐REAL Retrospective Cohort Analysis |
| title_fullStr | Association of Hypertriglyceridemia with All‐Cause Mortality and Atherosclerotic Cardiovascular Events in a Low‐Risk Italian Population: The TG‐REAL Retrospective Cohort Analysis |
| title_full_unstemmed | Association of Hypertriglyceridemia with All‐Cause Mortality and Atherosclerotic Cardiovascular Events in a Low‐Risk Italian Population: The TG‐REAL Retrospective Cohort Analysis |
| title_short | Association of Hypertriglyceridemia with All‐Cause Mortality and Atherosclerotic Cardiovascular Events in a Low‐Risk Italian Population: The TG‐REAL Retrospective Cohort Analysis |
| title_sort | association of hypertriglyceridemia with all cause mortality and atherosclerotic cardiovascular events in a low risk italian population the tg real retrospective cohort analysis |
| topic | all‐cause mortality atherosclerotic cardiovascular disease hypertriglyceridemia real‐world triglycerides |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.015801 |
| work_keys_str_mv | AT marcelloarca associationofhypertriglyceridemiawithallcausemortalityandatheroscleroticcardiovasculareventsinalowriskitalianpopulationthetgrealretrospectivecohortanalysis AT chiaraveronesi associationofhypertriglyceridemiawithallcausemortalityandatheroscleroticcardiovasculareventsinalowriskitalianpopulationthetgrealretrospectivecohortanalysis AT lauraderasmo associationofhypertriglyceridemiawithallcausemortalityandatheroscleroticcardiovasculareventsinalowriskitalianpopulationthetgrealretrospectivecohortanalysis AT claudioborghi associationofhypertriglyceridemiawithallcausemortalityandatheroscleroticcardiovasculareventsinalowriskitalianpopulationthetgrealretrospectivecohortanalysis AT furiocolivicchi associationofhypertriglyceridemiawithallcausemortalityandatheroscleroticcardiovasculareventsinalowriskitalianpopulationthetgrealretrospectivecohortanalysis AT gaetanomariadeferrari associationofhypertriglyceridemiawithallcausemortalityandatheroscleroticcardiovasculareventsinalowriskitalianpopulationthetgrealretrospectivecohortanalysis AT giovambattistadesideri associationofhypertriglyceridemiawithallcausemortalityandatheroscleroticcardiovasculareventsinalowriskitalianpopulationthetgrealretrospectivecohortanalysis AT robertopontremoli associationofhypertriglyceridemiawithallcausemortalityandatheroscleroticcardiovasculareventsinalowriskitalianpopulationthetgrealretrospectivecohortanalysis AT pierluigitemporelli associationofhypertriglyceridemiawithallcausemortalityandatheroscleroticcardiovasculareventsinalowriskitalianpopulationthetgrealretrospectivecohortanalysis AT valentinaperrone associationofhypertriglyceridemiawithallcausemortalityandatheroscleroticcardiovasculareventsinalowriskitalianpopulationthetgrealretrospectivecohortanalysis AT lucadegliesposti associationofhypertriglyceridemiawithallcausemortalityandatheroscleroticcardiovasculareventsinalowriskitalianpopulationthetgrealretrospectivecohortanalysis |