Abstract 13139: Fasting Triglycerides Are Independently Associated With Subclinical Atherosclerosis: The ELSA-Brasil Study

Abstract

Introduction: While triglycerides (TG) are associated with cardiovascular disease, most studies suggests that non-fasting TG drives this effect, whereas the role of fasting TG is less well established. Hypothesis: We have evaluated whether triglyceride-derived markers (log-transformed TG [lnTG], non-HDL, TG/HDL ratio) and HDL independently predict subclinical coronary artery disease as measured by the coronary artery calcium score (CAC). Methods: We included 2911 (50.3±8.5 years, 54% women) participants from the ELSA-Brasil study who had no prior history of CVD, were not currently using lipid-lowering medications and underwent CAC evaluation. We analyzed the independent association of triglyceride-derived markers (lnTG, non-HDL, TG/HDL ratio) and HDL with CAC using logistic regression. Results: Among the 2911 participants, 759 (26%) had a CAC >0, and 247 (8.5%) had a CAC > 100. The median triglycerides level was 112 (IQR: 80 -162). Individuals with CAC>0 had higher TG levels than those with CAC=0 (p<0.001). They also had higher levels of total cholesterol, LDL, non-HDL levels, lower HDL and higher TG/HDL ratios (all p<0.001). After adjustment for clinical risk factors log transformed TG, non-HDL and TG/HDL ratio remained significantly associated with CAC (allp<0.05), while HDL did not. Even after further adjustment for body mass-index (BMI) and for high sensitivity CRP, those predictors remained independently associated with CAC (table). Conclusions: In a large cohort of asymptomatic individuals, measures associated with fasting TG were associated with CAC score. Even after adjustment for clinical risk factors, BMI and hsCRP, measures associated with TG (lnTG, non-HDL and TG/HDL ratio) all remained independent predictors of CAC, while HDL did not. This suggests that TG may potentially be an independent target for therapy to reduce residual cardiovascular risk.