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Do triglycerides impact cardiovascular outcomes? A 10-year follow up study from a Portuguese cohort
Session:
Sessão de Posters 10 - Dislipidémia e metabolismo lipídico
Speaker:
Helena Sofia Santos Moreira
Congress:
CPC 2024
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.14 Risk Factors and Prevention - Other
Session Type:
Cartazes
FP Number:
---
Authors:
Helena Santos Moreira; Miguel Rocha; Pedro Mangas Palma; Ana Lebreiro; Afonso Rocha; Vitor Araújo; Joana Rodrigues; Paula Dias; Rui André Rodrigues
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Introduction: </span></strong><span style="color:black">Hypertriglyceridemia has long been described as a marker of increased cardiovascular (CV) risk. Even so, the intricate interplay of triglycerides (TG) and CV events is still a matter of ongoing debate, with recent trials showing controversial data. </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Purpose:</span></strong><span style="color:black"> The aim of this study was to determine whether TG level in very-high risk patients (pts) following acute coronary syndromes (ACS) is associated with major adverse CV outcomes at long-term follow-up (FUP). The primary composite endpoint included all-cause mortality and hospital admissions due to CV events.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Methods:</span></strong><span style="color:black"> We performed a retrospective analysis focusing on ACS pts who were admitted in our centre between 2008 and 2018. Comprehensive data including information from index event and posterior FUP was collected through medical records review. Pts were subsequently stratified in two groups according to TG level: group A with TG < 150 mg/dL and group B with TG ≥ 150 mg/dL. Statistical analysis was performed in SPSS software. </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Results: </span></strong><span style="color:black">A total of 591 pts were enrolled with a predominant male representation of 85.3% and a mean age of 55 (± 10) years old. The most frequent diagnosis at admission was myocardial infarction with ST segment elevation (49.6%, 293 pts). Smoking history (77.3%) and hypercholesterolemia (61.6%) were the most prevalent CV risk factors. After the acute phase, all pts underwent cardiac rehabilitation program (CRP), with nutritional support and lipid-lowering therapies intensification, namely high intensity statins. At the end of CRP visits, 23.2% of pts still fell into group B of the cohort, with a median TG level of 190 (IQR 75) mg/dL. The mean FUP time in overall analysis was 10 (± 2) years, with no statistically significant difference in both TG groups (p=0.351). During FUP, 159 (26.9%) pts reached the primary endpoint, with ACS representing most recurrent events (91 pts, 57%). When comparing groups A and B, the primary outcome was similar (122 vs 37 pts, p = 0.972) as so the time to its occurrence (figure 1), uncovering that pts in group B TG were not by itself significantly associated with increased risk of CV events. </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Conclusion:</span></strong><span style="color:black"> In agreement with the recent trials, our pragmatic study has brought to light the potential lack of long-term clinical impact associated with TG level reduction in pts with coronary artery disease. Further large scale randomized controlled trials are needed to comprehensively assess the significance of TG and their targeted therapies in the realm of secondary CV prevention.</span></span></span></p>
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