Differential effect of triglycerides on the prognosis of patients with a first versus recurrent acute coronary syndrome.

IF 4.4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Alberto Cordero, Rosa Fernandez Olmo, José R González-Juanatey, Leticia A Fernández-Freira, Sergio Manzano, Clara Bonanad, Gustavo Cortez, Armando Oterino, Belen Alvarez-Alvarez, Pedro J Flores Blanco, Jose M Castellano, Deepak L Bhatt
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引用次数: 0

Abstract

Background: There is divergent evidence of triglycerides on cardiovascular prevention that might be explained by confounding factors.

Methods: We performed a multicenter and retrospective study using the ongoing registries of acute coronary syndrome (ACS) patients of 8 hospitals from Spain. Triglycerides were measured during the hospitalization, and mortality and major adverse cardiovascular events (MACE) were analysed through follow-up.

Results: We included 14,483 patients discharged after an ACS. Median triglycerides level was 120.5 (interquartile range [IQRS] 90-197) mg/dL and was slightly higher in patients with recurrent ACS (135 IQR 98-186 vs. 129 IQR 95-175; p < .01). Through the follow-up, 34.7% of the patients experienced a first MACE rate and 15.0% died. Multivariate analysis identified that triglycerides levels were associated with a higher risk of MACE (HR 1.01 95% CI 1.00-1.02, p = .021) but not with all-cause mortality (HR: 1.00 95% .99-1.02, p = .17). A significant interaction (p = .01) was observed for triglycerides and previous ACS for both endpoints and, therefore, analyses were performed separately. Triglycerides were only associated with a higher risk of MACE in patients with recurrent ACS (HR 1.03 95% CI 1.01-1.05, p = .012) and a higher risk of death in patients with a first ACS (HR 1.02 95% CI 1.01-1.04, p = .02).

Conclusions: Previous ACS modifies the risk of triglycerides on MACE and mortality in patients discharged after an ACS. Triglycerides might be considered a target for treatment in patients after a first or recurrent ACS, although the expected benefit on outcomes might be different.

甘油三酯对首次与复发急性冠脉综合征患者预后的差异影响。
背景:甘油三酯预防心血管疾病的证据存在分歧,这可能是由混杂因素造成的。方法:我们对西班牙8家医院的急性冠脉综合征(ACS)患者进行了一项多中心回顾性研究。在住院期间测量甘油三酯,并通过随访分析死亡率和主要心血管不良事件(MACE)。结果:我们纳入了14483例ACS后出院的患者。中位甘油三酯水平为120.5(四分位数范围[IQRS] 90-197) mg/dL,复发性ACS患者的甘油三酯水平略高(135 IQR 98-186 vs 129 IQR 95-175;p结论:既往ACS可改变ACS后出院患者甘油三酯对MACE和死亡率的影响。甘油三酯可能被认为是首次或复发性ACS患者的治疗目标,尽管预期的结果可能不同。
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来源期刊
CiteScore
9.50
自引率
3.60%
发文量
192
审稿时长
1 months
期刊介绍: EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.
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