Lower Triglycerides Associated with Reduced Coronary Risk

Results from trial show 1.6-percent lower incidence with each 10 mg/dL drop in triglycerides

TUESDAY, Feb. 12 (HealthDay News) -- In patients with acute coronary syndrome, having triglycerides below 150 milligrams per deciliter is associated with a lower risk of recurrent coronary heart disease events, independent of their low-density lipoprotein cholesterol (LDL-C) level, according to research published in the Feb. 19 Journal of the American College of Cardiology.

Michael Miller, M.D., of the University of Maryland Medical Center in Baltimore, and colleagues analyzed data from the PROVE IT-TIMI 22 Trial, which evaluated the effect of different therapies to reduce LDL-C in 4,162 patients hospitalized with acute coronary syndrome. The researchers used a composite end point of death, myocardial infarction or recurrent acute coronary syndrome.

Having on-treatment triglycerides below 150 mg/dL was associated with reduced coronary heart disease risk (adjusted hazard ratio 0.80). With each 10 mg/dL decrease in on-treatment triglycerides, the incidence of the composite end point fell by 1.6 percent after adjustment for LDL-C.

"If a combined strategy of low LDL-C and low triglycerides proves to be more effective in reducing coronary heart disease events than intensive LDL-C lowering alone, then additional strategies might be considered after acute coronary syndrome, including replacement of saturated and trans fats with mono- and polyunsaturated fats, especially derivatives such as omega-3 fatty acids that are cardioprotective and at high doses possess triglyceride-lowering properties, or the addition of niacin- or fibrate-based therapy, which is currently under investigation for coronary heart disease event rate reduction beyond LDL-C lowering.

The PROVE IT-TIMI trial was funded by Bristol-Myers Squibb and Sankyo. Miller and several co-authors report financial relationships with a number of pharmaceutical companies.

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