Long-term prognostic utility of low-density lipoprotein (LDL) triglyceride in real-world patients with coronary artery d
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ORIGINAL INVESTIGATION
Cardiovascular Diabetology Open Access
Long‑term prognostic utility of low‑density lipoprotein (LDL) triglyceride in real‑world patients with coronary artery disease and diabetes or prediabetes Jing‑Lu Jin1†, Hui‑Wen Zhang1†, Ye‑Xuan Cao1, Hui‑Hui Liu1, Qi Hua2, Yan‑Fang Li3, Yan Zhang1, Yuan‑Lin Guo1, Na‑Qiong Wu1, Cheng‑Gang Zhu1, Rui‑Xia Xu1, Ying Gao1, Xiao‑Lin Li1, Chuan‑Jue Cui1, Geng Liu1, Jing Sun1, Qian Dong1, Raul Santos4,5 and Jian‑Jun Li1*
Abstract Background: Recent guidelines highlighted the association between atherosclerosis and triglyceride-enriched lipoproteins in patients with impaired glucose metabolism. However, evidence from prospective studies for long-term prognostic utility of low-density lipoprotein triglyceride (LDL-TG) in real-world patients with prediabetes (Pre-DM) or diabetes mellitus (DM) and coronary artery disease (CAD) is currently not available. The aim of the present study was to evaluate the impact of LDL-TG on major adverse cardiovascular events (MACEs) in patients with stable CAD under different glucose metabolism status. Methods: A total of 4381 patients with CAD were consecutively enrolled and plasma LDL-TG level was measured by an automated homogeneous assay. They were categorized according to both status of glucose metabolism [DM, Pre-DM, normal glycaemia regulation (NGR)] and tertiles of LDL-TG. All subjects were followed up for the occurrence of MACEs. Results: During a median of 5.1 (interquartile range 3.9 to 5.9) years’ follow-up, 507 (11.6%) MACEs occurred. Cubic spline models showed a significant association between LDL-TG and MACEs in DM and Pre-DM but not in NGR. When the combined effect of elevated LDL-TG and glucose disorders was considered for risk stratification, the medium tertile of LDL-TG plus DM, and the highest tertile of LDL-TG plus Pre-DM or plus DM subgroups were associated with significantly higher risk of MACEs after adjustment of confounders including triglyceride [hazard ratios (95% confi‑ dence intervals): 1.843 (1.149–2.955), 1.828 (1.165–2.867), 2.212 (1.396–3.507), all p
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