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

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Abstract
Aim: To determine whether high triglycerides (TG) in the presence of statin‐controlled LDL‐C influence the risk of cardiovascular disease (CVD) among patients with diabetes in real‐world clinical practice. Materials and methods: We identified adults with diabetes from the Southern California and Pacific Northwest regions of Kaiser Permanente. We included patients undergoing statin therapy with LDL‐C from 40‐100 mg/dL who were not undergoing other lipid‐lowering therapies and had a prior diagnosis of atherosclerotic CVD or at least one other CVD risk factor. We grouped patients into high TG (200‐499 mg/dL; n = 5542) or normal TG (P = 0.006). The rate was 23% higher for non‐fatal stroke (1.23, 1.01‐1.49, P = 0.037), 21% higher for coronary revascularization (rate ratio, 1.21; 95% CI, 1.02‐1.43; P = 0.027) and was, non‐significantly, 33% higher for unstable angina (rate ratio, 1.33; 95% CI, 0.87‐2.03; P = 0.185). Conclusions: Despite statin‐controlled LDL‐C levels, CV events were greater among patients with diabetes and high TG levels. Because we controlled for cardiometabolic risk factors, it is likely that the difference in TG levels contributed to the excess risk observed in patients with high TGs.
Funding Information
  • Amarin Pharma, Inc.

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