Role of triglycerides in coronary artery disease: lessons from the Prospective Cardiovascular Münster Study.
The incidence of atherosclerotic coronary artery disease (CAD) was assessed in 4,576 male participants of the Prospective Cardiovascular Münster (PROCAM) study, aged 40-64 years, over a 4-year follow-up period. In this time, 122 study participants developed atherosclerotic CAD (89 definite nonfatal myocardial infarctions and 33 definite atherosclerotic CAD deaths). Univariate analysis revealed a significant association between the incidence of atherosclerotic CAD, and high-density lipoprotein (HDL) cholesterol (p < 0.001) and triglyceride (p < 0.01) levels. The relation to HDL cholesterol remained after adjustment for other risk factors. By contrast, the relation between the incidence of atherosclerotic CAD and triglycerides disappeared if, in a multivariate analysis by means of a multiple logistic function, cholesterol or HDL cholesterol was taken into account. However, the data suggested that hypertriglyceridemia is a powerful additional coronary risk factor, when excessive triglycerides coincide with a high ratio (> 5.0) of plasma low-density lipoprotein (LDL) cholesterol to HDL cholesterol. Even though the prevalence of this subgroup was only 3.7%, it included a quarter of all atherosclerotic CAD events observed.
Assmann
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Institut für Arterioskleroseforschung, Universität Münster, Germany.
Schulte
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H
D000293:Adolescent; D000328:Adult; D000368:Aged; D002423:Cause of Death; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D008076:Cholesterol, HDL / Q000032:analysis; D008078:Cholesterol, LDL / Q000032:analysis; D003327:Coronary Disease / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015228:Hypertriglyceridemia / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000032:analysis / Q000502:physiology*
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides