AIMS To describe the real-world prevalence and consequences of hypertriglyceridaemia. MATERIALS AND METHODS We searched two large patient databases, the National Health and Nutrition Examination Survey (NHANES) database (2007-2014) and the Optum Research Database, as well as electronic medical records from two Kaiser Permanente regions. RESULTS The NHANES data showed that ~26% of US adults, including nearly one-third of statin users, had at least borderline hypertriglyceridaemia (triglycerides [TGs] ≥1.69 mmol/L), and ~40% of adults with diabetes had levels of ≥150 mg/dL despite statin use. The Optum analyses demonstrated that those with TG levels ≥1.69 mmol/L who were on statins had a significantly increased risk of composite initial major cardiovascular (CV) events (hazard ratio [HR] 1.26, 95% confidence interval [CI] 1.19-1.34; P < 0.001 vs. patients with TGs <150 mg/dL). This was accompanied by increased healthcare utilization and direct healthcare costs (HR 1.12, 95% CI 1.08-1.16; P < 0.001). In the analyses of the Kaiser Permanente records, patients with diabetes and TG levels 2.26-5.64 mmol/L had significantly higher adjusted incidence rates of non-fatal myocardial infarction (rate ratio 1.30, 95% CI 1.08-1.58; P = 0.006), non-fatal stroke (rate ratio 1.23; 95% CI 1.01-1.49; P = 0.037) and coronary revascularization (rate ratio 1.21; 95% CI 1.02-1.43; P = 0.027), but not unstable angina (rate ratio 1.33; 95% CI 0.87-2.03; P = 0.185) compared with patients with TG levels <1.69 mmol/L. CONCLUSIONS Real-world analyses suggest that elevated TGs are prevalent and commonly associated with increased CV risk. CV outcomes trials in patients with established hypertriglyceridaemia will clarify whether strategies to reduce TG levels can ameliorate residual CV risk in patients taking statins.

中文翻译：

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高甘油三酯血症患者心血管事件的风险：现实世界证据的回顾。


目的 描述现实世界中高甘油三酯血症的患病率和后果。材料和方法 我们检索了两个大型患者数据库：国家健康和营养检查调查 (NHANES) 数据库（2007-2014 年）和 Optum 研究数据库，以及来自两个 Kaiser Permanente 地区的电子病历。结果 NHANES 数据显示，约 26% 的美国成年人（包括近三分之一的他汀类药物使用者）至少患有临界高甘油三酯血症（甘油三酯 [TG] ≥1.69 mmol/L），约 40% 的成人糖尿病患者的水平为尽管使用他汀类药物，仍≥150 mg/dL。 Optum 分析表明，TG 水平≥1.69 mmol/L 且服用他汀类药物的患者发生复合初始主要心血管 (CV) 事件的风险显着增加（风险比 [HR] 1.26，95% 置信区间 [CI] 1.19-1.34） ；与 TG <150 mg/dL 的患者相比，P < 0.001)。随之而来的是医疗保健利用率和直接医疗保健成本的增加（HR 1.12，95% CI 1.08-1.16；P < 0.001）。在Kaiser Permanente记录的分析中，TG水平为2.26-5.64 mmol/L的糖尿病患者的非致命性心肌梗死调整后发病率显着较高（比率1.30，95% CI 1.08-1.58；P = 0.006），非致命性卒中（发生率比 1.23；95% CI 1.01-1.49；P = 0.037）和冠状动脉血运重建（发生率比 1.21；95% CI 1.02-1.43；P = 0.027），但不稳定心绞痛（发生率比 1.33；95）与 TG 水平 <1.69 mmol/L 的患者相比，% CI 0.87-2.03；P = 0.185。结论 现实世界的分析表明，甘油三酯升高很普遍，并且通常与心血管风险增加相关。 对患有高甘油三酯血症的患者进行的心血管结局试验将阐明降低甘油三酯水平的策略是否可以改善服用他汀类药物的患者的残余心血管风险。