Abstract
ObjectivesTo 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. MethodsA 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.).ResultsOf 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.ConclusionsMany 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.
Highlights
A low occurrence of pancreatitis was noted in our series
Cardiovascular diseases and atherosclerosis have been associated with low-density lipoprotein cholesterol (LDL-C) levels in the last decade, but growing evidence supports the positive relationship between cardiovascular diseases and high levels of triglycerides (TG) [1]
Our study focused on the association of TG as an independent risk factor for cardiovascular disease (CVD) in Saudi adults
Summary
Cardiovascular diseases and atherosclerosis have been associated with low-density lipoprotein cholesterol (LDL-C) levels in the last decade, but growing evidence supports the positive relationship between cardiovascular diseases and high levels of triglycerides (TG) [1]. Elevated TG is associated with pancreatitis but other systems may be affected. TG elevation could be primary or familial or due to a secondary cause, such as uncontrolled diabetes, obesity, or alcohol consumption. A high TG, in many cases, is asymptomatic until it exceeds 500 - 1,000 mg/dL (5.7 mmol/L or above) [2]. TG was considered a major independent risk related to LDL-C or to its lowering therapy [3]. The prevalence of high TG in Saudi Arabia is estimated at 40.3% [4]
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