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
{"title":"Differential effect of triglycerides on the prognosis of patients with a first versus recurrent acute coronary syndrome.","authors":"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","doi":"10.1111/eci.70072","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There is divergent evidence of triglycerides on cardiovascular prevention that might be explained by confounding factors.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70072"},"PeriodicalIF":4.4000,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Clinical Investigation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/eci.70072","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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.
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