Fan Wenjun, Philip Sephy, Granowitz Craig, Toth Peter P, Wong Nathan D
Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA, USA.
Amarin Pharma, Inc, Bridgewater, NJ, USA.
Cardiol Ther. 2020 Jun;9(1):207-213. doi: 10.1007/s40119-020-00170-x. Epub 2020 Apr 23.
Hypertriglyceridemia is associated with increased atherosclerotic cardiovascular disease (ASCVD) event risk, which persists even in statin-treated patients. The objective of this analysis was to estimate the prevalence of triglyceride (TG) levels ≥ 150 mg/dl in statin-treated adults with diabetes or ASCVD in the United States.
Laboratory data, medical history, and prescription data from 40,617 subjects who participated in the US National Health and Nutrition Examination Survey (NHANES) spanning 8 years (four 2-year surveys; 2007-2014) were analyzed. Patients included were ≥ 20 years old and had morning fasting (at least 8.5 h) TG values available. The proportion and weighted number of individuals in the US population with TG ≥ 150 mg/dl was calculated according to statin use, as well as in key subgroups of statin-treated patients including those with low-density lipoprotein cholesterol (LDL-C) levels < 100 mg/dl, type 2 diabetes, ASCVD, and those with type 2 diabetes and ASCVD.
A total of 9593 subjects, projected to represent 219.9 million Americans, met the study entry criteria and were included in the analysis. Of these, 2523 had TG levels ≥ 150 mg/dl, translating to a prevalence of 25.9% and representing 56.9 million Americans. Among statin-treated adults, the proportion with TG levels ≥ 150 mg/dl was 31.6% (12.3 million) and ranged from 27.6 to 39.5% for those who also had LDL-C levels < 100 mg/dl and type 2 diabetes or ASCVD.
Over 12 million Americans are treated with a statin and have TG levels ≥ 150 mg/dl. Interventions such as icosapent ethyl that have been shown to reduce ASCVD event risk in this elevated TG population with type 2 diabetes or established ASCVD can provide substantial clinical benefit for these patients.
高甘油三酯血症与动脉粥样硬化性心血管疾病（ASCVD）事件风险增加相关，即便在接受他汀类药物治疗的患者中这种风险依然存在。本分析的目的是估算美国患有糖尿病或ASCVD的成年他汀类药物治疗患者中甘油三酯（TG）水平≥150mg/dl的患病率。
分析了来自参与美国国家健康与营养检查调查（NHANES）长达8年（4次为期2年的调查；2007 - 2014年）的40617名受试者的实验室数据、病史和处方数据。纳入的患者年龄≥20岁且有早晨空腹（至少8.5小时）的TG值。根据他汀类药物使用情况以及他汀类药物治疗患者的关键亚组（包括低密度脂蛋白胆固醇（LDL - C）水平<100mg/dl、2型糖尿病、ASCVD以及同时患有2型糖尿病和ASCVD的患者）计算美国人群中TG≥150mg/dl的个体比例和加权人数。
共有9593名受试者符合研究纳入标准并被纳入分析，预计代表2.199亿美国人。其中，2523人的TG水平≥150mg/dl，患病率为25.9%，代表5690万美国人。在接受他汀类药物治疗的成年人中，TG水平≥150mg/dl的比例为31.6%（1230万），对于同时LDL - C水平<100mg/dl以及患有2型糖尿病或ASCVD的患者，该比例在27.6%至39.5%之间。
超过1200万美国人接受他汀类药物治疗且TG水平≥150mg/dl。已证明二十碳五烯酸乙酯等干预措施可降低患有2型糖尿病或已确诊ASCVD的高TG人群的ASCVD事件风险，可为这些患者带来显著的临床益处。
