Average triglyceride (TG) levels correlate more with coronary heart disease (CHD) risk than a single point-in-time TG level, according to research presented at the American College of Cardiology 68th Annual Scientific Session & Expo, held March 16-18, 2019 in New Orleans, Louisiana.

Measured levels of TG vary considerably and it is unclear how to best evaluate TG-associated CHD risk. Using data from the Framingham Offspring Study, researchers in the present study evaluated the associations between TG and CHD events (angina, myocardial infarction, revascularization, and CV death) in adults who were free of cardiovascular disease (CVD) by 55 years old (age range 53 to 57).

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A Cox proportional hazards model was used to determine the strength association between various TG measures (including baseline TG, maximum TG, average TG across all exams, standard deviation of TG levels, area under the curve of TG, and coefficient of TG variation over time) and subsequent CHD events.

Among the 1336 adults without CHD identified (median age 55, 53% women, 5.4% with diabetes), the 10-year Kaplan-Meier CHD event rate was 6.9%. Of the various measures of TG, the most strongly related to CHD events was average TG over prior years (C-index 0.67), followed by maximum TG (C-index 0.65), area under the curve of TG (0.64), TG at first exam (0.64), and TG at baseline (0.63).

A nonlinear association was found between average TG and future risk for CHD (P <.0001). Risk of CVD increased with TG increases up to 150 mg/dL (HR 1.19 per 10 mg/dL increase, 95% CI, 1.13-1.26), above which the association was flat.

Study investigators conclude that these results indicate that “average TG are more correlated with CHD risk than a single point-in-time TG level. Even with TGs below 150 mg/dL, CHD risk rises rapidly with increasing TGs.”

ReferenceAverage triglycerides over prior years were most strongly related to coronary heart disease events.

Navar AM, Pagidipati N, Mulder H, et al. Triglycerides as a risk factor for coronary heart disease: what measure and what cutoff? Presented at: American College of Cardiology 68th Annual Scientific Session & Expo; March 16-18, 2019; New Orleans, LA. Abstract 1331-414.