AIMS Hypertriglyceridaemia in patients with atherosclerotic cardiovascular disease (ASCVD) has been in focus following the REDUCE-IT trial showing benefit with icosapent ethyl. Among individuals with prevalent ASCVD, we sought to quantify the contemporary, real-world risk of ASCVD events associated with hypertriglyceridaemia, as well as estimate icosapent ethyl eligibility and compare trial participants with REDUCE-IT-like individuals in the population. METHODS AND RESULTS We examined data from 2 424 865 adults with lipid panels in the Ontario population. Among those with prevalent ASCVD, we examined adjusted associations between triglyceride (TG) and ASCVD events (first occurrence of myocardial infarction, unstable angina, stroke or transient ischaemic attack, coronary revascularization, or cardiovascular death). The proportion of patients with ASCVD potentially eligible for icosapent ethyl was estimated as those with TG 135-499 mg/dL (1.52-5.63 mmol/L) and low-density lipoprotein cholesterol (LDLc) 41-100 mg/dL (1.06-2.59 mmol/L), similar to the lipid cut-offs in REDUCE-IT, and their demographics and event rates examined. Among 196 717 individuals with ASCVD, median age was 69 years and 30% were female. A total of 24 097 composite ASCVD events occurred over a mean (standard deviation) 2.9 (0.5) years of follow-up. Increasing TG was associated with a graded, progressively higher hazard of ASCVD events. Twenty-five percent (49 886) of individuals with ASCVD had hypertriglyceridaemia and controlled LDLc; these patients were demographically similar to those in REDUCE-IT with comparable event rates. CONCLUSIONS Among patients with ASCVD, hypertriglyceridaemia is common, and is associated with higher ASCVD risk across a range of TG. It is possible that as many as one in four patients with ASCVD may be candidates for emerging therapies.

中文翻译：

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与动脉粥样硬化性心血管疾病患者的高甘油三酯血症相关的心血管结局的真实世界风险以及新兴疗法的潜在资格

AIMS 动脉粥样硬化性心血管疾病 (ASCVD) 患者的高甘油三酯血症一直是关注的焦点，因为 REDUCE-IT 试验显示使用 icosapent ethyl 的益处。在患有普遍 ASCVD 的个体中，我们试图量化与高甘油三酯血症相关的 ASCVD 事件的当代真实世界风险，以及估计 icosapent ethyl 的资格并将试验参与者与人群中的 REDUCE-IT 样个体进行比较。方法和结果 我们检查了安大略省人群中 2 424 865 名患有血脂检查的成年人的数据。在患有 ASCVD 的人群中，我们检查了甘油三酯 (TG) 与 ASCVD 事件（首次发生心肌梗死、不稳定型心绞痛、中风或短暂性脑缺血发作、冠状动脉血运重建或心血管死亡）之间的调整关联。估计有可能符合 icosapent ethyl 的 ASCVD 患者比例为 TG 135-499 mg/dL (1.52-5.63 mmol/L) 和低密度脂蛋白胆固醇 (LDLc) 41-100 mg/dL (1.06-2.59) mmol/L)，类似于 REDUCE-IT 中的脂质临界值，并检查了它们的人口统计和事件发生率。在 196 717 名 ASCVD 患者中，中位年龄为 69 岁，30% 为女性。在平均（标准差）2.9（0.5）年的随访中，总共发生了 24097 起复合 ASCVD 事件。增加的 TG 与分级的、逐渐增加的 ASCVD 事件风险相关。25% (49 886) 的 ASCVD 患者有高甘油三酯血症和控制的 LDLc；这些患者在人口统计学上与 REDUCE-IT 中的患者相似，事件发生率相当。结论 在 ASCVD 患者中，高甘油三酯血症很常见，并且在一系列 TG 中与较高的 ASCVD 风险相关。多达四分之一的 ASCVD 患者可能是新兴疗法的候选者。