Serum triglycerides in the prediction of coronary artery disease (an Italian experience)

Menotti, Alessandro; Scanga, M.; Morisi, G

doi:10.1016/0002-9149(94)90722-6

Cited by 18 publications

(13 citation statements)

References 23 publications

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“…To avoid double counting, we considered only one analysis of any cohort (except for subpopulations) – typically the most recent publication meeting the inclusion criteria. Multiple articles reporting the Copenhagen Male Study (CMS),28–30 Caerphilly and Speedwell Collaborative Heart Disease Studies (CSCHDS),15,52 Framingham Heart Study (FHS; for men but not women),20,51 Prospective Cardiovascular Münster Study (PROCAM),12–14 Lipid Research Clinics Prevalence and Mortality Follow-Up Study (LRC-FS),11,19 Nurses’ Health Study (NHS),43,44 and occupational groups examined in Rome (ROG)35,36 cohorts typically agreed on the study result (significance of the association between triglycerides and CHD) or reached a consensus. Two reports of the Multiple Risk Factor Intervention Trial (MRFIT) study disagreed, however: the 25-year follow-up analysis reported a significant association, whereas a 6.1-year follow-up did not (the article reporting the 25-year follow-up was used for the MRFIT study) 11,22.…”

Section: Methodsmentioning

confidence: 99%

“…Two reports of the Multiple Risk Factor Intervention Trial (MRFIT) study disagreed, however: the 25-year follow-up analysis reported a significant association, whereas a 6.1-year follow-up did not (the article reporting the 25-year follow-up was used for the MRFIT study) 11,22. After excluding duplicate reports of the same cohort, a report in which the outcome was all-cause deaths,24 and a report in which the outcome was heart failure,26 32 reports with coronary events or coronary death as outcome remained and were included in the analysis 11,14,18,20–23,25,27,30–32,34,36–50,52,54–56. As some articles described more than one cohort,11 more than one subpopulation of a cohort (eg, men and women separately), and we included only one outcome measure per cohort (coronary events only, if coronary deaths were also reported), results for a total of 38 different populations were included in the analysis.…”

Section: Methodsmentioning

confidence: 99%

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The independent relationship between triglycerides and coronary heart disease

Morrison

Hokanson

2008

VHRM

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Aims:The aim was to review epidemiologic studies to reassess whether serum levels of triglycerides should be considered independently of high-density lipoprotein-cholesterol (HDL-C) as a predictor of coronary heart disease (CHD). Methods and results:We systematically reviewed population-based cohort studies in which baseline serum levels of triglycerides and HDL-C were included as explanatory variables in multivariate analyses with the development of CHD (coronary events or coronary death) as dependent variable. A total of 32 unique reports describing 38 cohorts were included. The independent association between elevated triglycerides and risk of CHD was statistically signifi cant in 16 of 30 populations without pre-existing CHD. Among populations with diabetes mellitus or pre-existing CHD, or the elderly, triglycerides were not signifi cantly independently associated with CHD in any of 8 cohorts. Triglycerides and HDL-C were mutually exclusive predictors of coronary events in 12 of 20 analyses of patients without pre-existing CHD. Conclusions: Epidemiologic studies provide evidence of an association between triglycerides and the development of primary CHD independently of HDL-C. Evidence of an inverse relationship between triglycerides and HDL-C suggests that both should be considered in CHD risk estimation and as targets for intervention.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The independent relationship between triglycerides and coronary heart disease

Morrison

Hokanson

2008

VHRM

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“…[2][3][4][5][6][7][8]10 However, adjustment for other coronary risk factors, and in particular HDL cholesterol, usually reduced or eliminated the independent association between triglycerides and CHD risk. 4 -8 Several authors 11,19,23 have questioned whether it is judicious to adjust for HDL cholesterol levels when the relation between triglyceride levels and CHD morbidity and mortality is being assessed.…”

Section: Circulation August 3 1999mentioning

confidence: 99%

“…Several studies [2][3][4][5][6][7][8][9][10] conducted in healthy persons, mostly men, showed that elevated triglyceride levels were associated with increased risk for coronary heart disease (CHD). In most of these studies, [2][3][4][5][6][7][8] the positive relation between triglyceride levels and CHD risk persisted after adjustment for possible confounders but disappeared after HDL cholesterol was introduced into the multivariate model. Several investigators reasoned that the introduction of both HDL cholesterol and triglycerides as independent covariates was inappropriate owing to multicollinearity and an intimate link between these variables in lipid metabolism.…”

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confidence: 99%

Elevated Serum Triglyceride Levels and Long-Term Mortality in Patients With Coronary Heart Disease

et al. 1999

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for the BIP Study GroupBackground-The association between elevated blood triglyceride levels and subsequent mortality risk in patients with established coronary heart disease (CHD) has been investigated rarely. The aim of the present study was to investigate this association. Methods and Results-We evaluated mortality over a mean follow-up time of 5.1 years among 9033 male and 2499 female CHD patients who were screened for participation in the Bezafibrate Infarction Prevention (BIP) Study. A stepwise increase in mortality with increasing serum triglyceride levels was observed in patients with desirable or elevated serum total cholesterol levels and in patients with either desirable or abnormally low HDL cholesterol levels. Multivariate adjustment for factors other than HDL cholesterol yielded a slightly increased adjusted mortality risk with a 1-natural-log-unit elevation of triglyceride levels in men (hazard ratio [HR] 1.14, 95% CI 1.00 to 1.30) and women (HR 1.37, 95% CI 1.04 to 1.88). Excess covariate-adjusted risk was noted among patients with elevated total and LDL cholesterol and in women with HDL cholesterol levels Ͼ45 mg/dL. After additional adjustment for HDL cholesterol, the risk of mortality with a 1-natural-log-unit elevation of triglycerides declined in men (HR 1.09, 95% CI 0.94 to 1.26) and in women (HR 1.10, 95% CI 0.80 to 1.50). A trend for increased mortality risk remained in patients with elevated total and LDL cholesterol and in women with HDL cholesterol Ͼ45 mg/dL. Conclusions-Elevated triglyceride levels were associated with a small, independent increased mortality risk in CHD patients. This risk may be increased among subgroups of patients with elevated total cholesterol and LDL cholesterol levels. (Circulation. 1999;100:475-482.)

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“…[7][8][9][10][11][12][13][14][15][16][17] The Copenhagen Male Study, which followed 2,906 white men over 8 years, found that fasting TG was independently associated with the incidence of CAD. However, when adjusted for HDL-C and low-density lipoprotein (LDL) cholesterol levels, TG did not increase the risk for CAD.…”

Section: Discussionmentioning

confidence: 99%