Jar Raghad A, Melibari Ealaf, Almehmadi Nidaa, Kalantan Renad O, Ahmed Mohamed E, Kinsara Abdulhalim J
Medicine and Surgery, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU.
Biostatistics, King Abdullah International Medical Research Center, Jeddah, SAU.
Cureus. 2021 Dec 27;13(12):e20732. doi: 10.7759/cureus.20732. eCollection 2021 Dec.
Objectives To estimate the prevalence of hypertriglyceridemia (HTG), determine the association between HTG and the risk of ischemic heart disease and major adverse cardiovascular events. Lastly, to assess the management outcomes of HTG in terms of the different drugs in the treatment plan. Methods A retrospective, longitudinal study at a tertiary hospital was conducted. All who came in were screened. Patients with HTG (TAG [triacylglyceride] 2.3 mmol/L) in the last five years were included in the study. The data included the demographic variables, potential causes, and the methods of management. All data were recorded in a standard data collection form and analyzed by an appropriate statistical tool, using the John Macintosh Project (JMP) software version 15 (Cary, NC: SAS Institute Inc.). Results Of 300 patients included, 174 (58.0%) were male, with a mean age of 57.8±13.4 years. Pre-treatment, the mean triglycerides (TG) was 3.2±2.3 mmol/L, low-density lipoprotein (LDL) 2.7±1.3 mmol/L, high-density lipoprotein (HDL) 0.93±0.30 mmol/L, and the total cholesterol (TC)was 5.2±1.3 mmol/L. All the patients have prescribed a statin, 144 (48.0%) received aspirin, six (2.0%) fenofibrate, and three (1.0%) gemfibrozil. At the follow-up, the level of the TG was 2.6±1.3 mmol/L (P=0.001), LDL 2.5±1.2 mmol/L (P=0.006) and total cholesterol (TC) 4.7±1.5 mmol/L (P=0.001). Almost a third (28.2%) developed cardiac complications, five (1.6%) presented with unstable angina, six (2.0%) as non-ST segment elevation myocardial infarction (NSTEMI), three (1.0%) had ST segment elevation myocardial infarction (STEMI), and 19 (6.3%) had heart failure. A small proportion (17.3%) had a percutaneous coronary intervention, 27 (9.0%) had single-vessel disease, 12 (4.0%) two-vessel disease, and 13 (4.3%) three-vessel disease. Conclusions Many physicians do not pay attention to HTG in everyday practice, although HTG contributes significantly to the occurrence of coronary heart disease. In our study, the majority had mixed hyperlipidemia. One-third of patients with high triglycerides developed ischemic heart disease. The use of fenofibrate and gemfibrozil was not high. A low occurrence of pancreatitis was noted in our series.
评估高甘油三酯血症（HTG）的患病率，确定HTG与缺血性心脏病风险及主要不良心血管事件之间的关联。最后，根据治疗方案中不同药物评估HTG的管理效果。方法：在一家三级医院进行了一项回顾性纵向研究。对所有前来就诊的患者进行筛查。纳入过去五年中患有HTG（甘油三酯[TAG]≥2.3 mmol/L）的患者。数据包括人口统计学变量、潜在病因和管理方法。所有数据均记录在标准数据收集表中，并使用约翰·麦金托什项目（JMP）软件版本15（北卡罗来纳州卡里：SAS Institute Inc.）通过适当的统计工具进行分析。结果：纳入的300例患者中，174例（58.0%）为男性，平均年龄为57.8±13.4岁。治疗前，平均甘油三酯（TG）为3.2±2.3 mmol/L，低密度脂蛋白（LDL）为2.7±1.3 mmol/L，高密度脂蛋白（HDL）为0.93±0.30 mmol/L，总胆固醇（TC）为5.2±1.3 mmol/L。所有患者均开具了他汀类药物，144例（48.0%）接受了阿司匹林治疗，6例（2.0%）接受了非诺贝特治疗，3例（1.0%）接受了吉非贝齐治疗。随访时，TG水平为2.6±1.3 mmol/L（P = 0.001），LDL为2.5±1.2 mmol/L（P = 0.006），总胆固醇（TC）为4.7±1.5 mmol/L（P = 0.001）。近三分之一（28.2%）发生了心脏并发症，5例（1.6%）出现不稳定型心绞痛，6例（2.0%）为非ST段抬高型心肌梗死（NSTEMI），3例（1.0%）发生ST段抬高型心肌梗死（STEMI），19例（6.3%）发生心力衰竭。一小部分（17.3%）接受了经皮冠状动脉介入治疗，27例（9.0%）为单支血管病变，12例（4.0%）为双支血管病变，13例（4.3%）为三支血管病变。结论：尽管HTG对冠心病的发生有显著影响，但许多医生在日常实践中并不重视HTG。在我们的研究中，大多数患者为混合性高脂血症。三分之一的高甘油三酯患者发生了缺血性心脏病。非诺贝特和吉非贝齐的使用比例不高。我们的系列研究中胰腺炎的发生率较低。
