title: Plasma triglyceride levels increase the risk for recurrent vascular events independent of LDL-cholesterol or nonHDL-cholesterol.
abstract: BACKGROUND
  Plasma triglyceride (TG) levels are known to confer an increased risk of vascular disease in healthy populations, but data in high-risk patients are scarce. In this study we evaluated the risk on recurrent vascular events conferred by increased plasma TG levels in patients with various clinical manifestations of vascular disease.
  
  
  METHODS
  Prospective cohort study of 5731 patients with clinically manifest vascular disease.
  
  
  RESULTS
  First new vascular events (myocardial infarction, ischemic stroke, vascular death) occurred in 782 subjects during a median follow-up of 4.9 years (interquartile range 2.5-8.1 years). Patients in the highest plasma TG quintile (>2.24 mmol/L) had a higher risk for recurrent vascular events (HR 1.45; 95%CI 1.13-1.86) compared with the lowest plasma TG quintile (<0.97 mmol/L) after adjustments for age, gender, body mass index, smoking, lipid-lowering medication and low-density lipoprotein-cholesterol. The increased risk associated with increasing plasma TG levels was irrespective of the presence of type 2 diabetes (T2DM), but only present in patients without the metabolic syndrome. Furthermore, the increased risk was particularly present in patients with coronary artery disease (CAD) (HR 1.45; 95%CI 1.02-2.08) and was not modified by other lipid levels (p-value for interaction >0.05). Plasma TG still contributed to vascular risk when other lipid levels were at target level.
  
  
  CONCLUSIONS
  Higher plasma TG levels are associated with increased risk for recurrent vascular events, in particular in CAD patients. This increased risk is independent of the presence of T2DM and the use of lipid-lowering medication and is not modified by other lipid levels.
authors.affiliation: Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Anton P
authors.initials: AP
authors.lastname: van de Woestijne
authors.forename: Annemarie M J
authors.initials: AM
authors.lastname: Wassink
authors.forename: Houshang
authors.initials: H
authors.lastname: Monajemi
authors.forename: An-Ho
authors.initials: AH
authors.lastname: Liem
authors.forename: Hendrik M
authors.initials: HM
authors.lastname: Nathoe
authors.forename: Yolanda
authors.initials: Y
authors.lastname: van der Graaf
authors.forename: Frank L J
authors.initials: FL
authors.lastname: Visseren
mesh_terms: D000368:Aged; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*; D014652:Vascular Diseases / Q000097:blood* / Q000175:diagnosis*
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D002784:Cholesterol