Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China.
West China School of Medicine, Sichuan University, Chengdu, China.
Lipids Health Dis. 2019 Jan 22;18(1):21. doi: 10.1186/s12944-019-0972-0.
The role of triglyceride (TG) in secondary prevention of patients with coronary artery disease (CAD) was debated. In the present study, we assessed the association between admission TG levels and long-term mortality risk in CAD patients.
A retrospective analysis was conducted from a single registered database. 3061 consecutive patients with CAD confirmed by coronary angiography were enrolled and were grouped into 3 categories by the tertiles of admission serum TG levels. The primary end point in this study was all-cause mortality and the secondary end point was cardiovascular mortality.
The mean follow-up time was 26.9 ± 13.6 months and death events occurred in 258 cases and cardiovascular death events occurred in 146 cases. Cumulative survival curves indicated that the risk of all-cause death decreased with increasing TG level (Tertile 1 vs. Tertile 2 vs. Tertile 3 = 10.3% vs. 8.6% vs. 6.3%, log rank test for overall p = 0.001). Cox regression analysis showed an independent correlation between TG level and risk of all-cause mortality [hazard ratio (HR) 0.71, 95% confidence interval (CI) 0.58-0.86] and cardiovascular mortality (HR 0.67, 95% CI 0.51-0.89) in total patients with CAD. Subgroup analysis found the similar results in patients with acute coronary syndrome and acute myocardial infarction.
This study found an inverse association between TG levels and mortality risk in CAD patients, which suggests that the "TG paradox" may exist in CAD patients.
ChiCTR, ChiCTR-OOC-17010433 . Registered 17 February 2017 - Retrospectively registered.
甘油三酯（TG）在冠心病（CAD）患者二级预防中的作用存在争议。本研究旨在评估入院时 TG 水平与 CAD 患者长期死亡风险之间的关系。
回顾性分析来自单个注册数据库的资料。共纳入 3061 例经冠状动脉造影确诊的 CAD 患者，并根据入院时血清 TG 水平的三分位值将其分为 3 组。本研究的主要终点为全因死亡率，次要终点为心血管死亡率。
平均随访时间为 26.9±13.6 个月，共有 258 例患者死亡，146 例患者发生心血管死亡。累积生存曲线表明，全因死亡风险随 TG 水平的升高而降低（三分位 1 组比三分位 2 组比三分位 3 组分别为 10.3%比 8.6%比 6.3%，整体 log rank 检验 p=0.001）。Cox 回归分析显示，TG 水平与 CAD 患者全因死亡风险[风险比（HR）0.71，95%置信区间（CI）0.580.86]和心血管死亡风险（HR 0.67，95% CI 0.510.89）独立相关。亚组分析发现，在急性冠状动脉综合征和急性心肌梗死患者中也得到了类似的结果。
本研究发现 CAD 患者的 TG 水平与死亡率风险呈负相关，提示 CAD 患者可能存在“TG 悖论”。
ChiCTR，ChiCTR-OOC-17010433。注册日期：2017 年 2 月 17 日。- 回顾性注册。
