Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease (Feb 2024)
Prognostic Value and Relative Cutoffs of Triglycerides Predicting Cardiovascular Outcome in a Large Regional‐Based Italian Database
- Valérie Tikhonoff,
- Edoardo Casiglia,
- Agostino Virdis,
- Guido Grassi,
- Fabio Angeli,
- Marcello Arca,
- Carlo M. Barbagallo,
- Michele Bombelli,
- Federica Cappelli,
- Rosario Cianci,
- Arrigo F. G. Cicero,
- Massimo Cirillo,
- Pietro Cirillo,
- Raffaella Dell'oro,
- Lanfranco D'elia,
- Giovambattista Desideri,
- Claudio Ferri,
- Ferruccio Galletti,
- Loreto Gesualdo,
- Cristina Giannattasio,
- Guido Iaccarino,
- Francesca Mallamaci,
- Alessandro Maloberti,
- Stefano Masi,
- Maria Masulli,
- Alberto Mazza,
- Alessandro Mengozzi,
- Maria Lorenza Muiesan,
- Pietro Nazzaro,
- Paolo Palatini,
- Gianfranco Parati,
- Roberto Pontremoli,
- Fosca Quarti‐Trevano,
- Marcello Rattazzi,
- Gianpaolo Reboldi,
- Giulia Rivasi,
- Elisa Russo,
- Massimo Salvetti,
- Pier Luigi Temporelli,
- Giuliano Tocci,
- Andrea Ungar,
- Paolo Verdecchia,
- Francesca Viazzi,
- Massimo Volpe,
- Claudio Borghi
Affiliations
- Valérie Tikhonoff
- Department of Medicine Università degli Studi di Padova Via Giustiniani 8 Padua 35128 Italy
- Edoardo Casiglia
- Studium Patavinum, Department of Medicine Università degli Studi di Padova Padua Italy
- Agostino Virdis
- Department of Clinical and Experimental Medicine University of Pisa Italy
- Guido Grassi
- Department of Medicine and Surgery University of Milano‐Bicocca Monza Italy
- Fabio Angeli
- Department of Medicine and Surgery University of Insubria Varese Italy
- Marcello Arca
- Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
- Carlo M. Barbagallo
- Biomedical Department of Internal Medicine and Specialistics University of Palermo Italy
- Michele Bombelli
- Department of Medicine and Surgery University of Milano‐Bicocca Monza Italy
- Federica Cappelli
- Department of Clinical and Experimental Medicine University of Pisa Italy
- Rosario Cianci
- Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy
- Arrigo F. G. Cicero
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department Alma Mater Studiorum University of Bologna Bologna Italy
- Massimo Cirillo
- Department of Medicine “Scuola Medica Salernitana” University of Salerno Baronissi (SA) Italy
- Pietro Cirillo
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation “Aldo Moro” University of Bari Bari Italy
- Raffaella Dell'oro
- Department of Medicine and Surgery University of Milano‐Bicocca Monza Italy
- Lanfranco D'elia
- Department of Clinical Medicine and Surgery “Federico II” University of Naples Medical School Naples Italy
- Giovambattista Desideri
- Department of Life, Health and Environmental Sciences University of L’Aquila Italy
- Claudio Ferri
- Department of Life, Health and Environmental Sciences University of L’Aquila Italy
- Ferruccio Galletti
- Department of Clinical Medicine and Surgery “Federico II” University of Naples Medical School Naples Italy
- Loreto Gesualdo
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation “Aldo Moro” University of Bari Bari Italy
- Cristina Giannattasio
- Cardiology IV, “A.De Gasperi’s” Department Niguarda Ca’ Granda Hospital Milan Italy
- Guido Iaccarino
- Department of Advanced Biomedical Sciences “Federico II” University of Naples Naples Italy
- Francesca Mallamaci
- CNR‐IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit Reggio Calabria Italy
- Alessandro Maloberti
- Cardiology IV, “A.De Gasperi’s” Department Niguarda Ca’ Granda Hospital Milan Italy
- Stefano Masi
- Department of Clinical and Experimental Medicine University of Pisa Italy
- Maria Masulli
- Department of Clinical Medicine and Surgery “Federico II” University of Naples Medical School Naples Italy
- Alberto Mazza
- Department of Internal Medicine Santa Maria della Misericordia General Hospital, AULSS 5 Polesana Rovigo Italy
- Alessandro Mengozzi
- Department of Clinical and Experimental Medicine University of Pisa Italy
- Maria Lorenza Muiesan
- Department of Clinical and Experimental Sciences University of Brescia Italy
- Pietro Nazzaro
- Department of Medical Basic Sciences, Neurosciences and Sense Organs University of Bari Medical School Bari Italy
- Paolo Palatini
- Studium Patavinum, Department of Medicine Università degli Studi di Padova Padua Italy
- Gianfranco Parati
- S. Luca Hospital Istituto Auxologico Italiano and University of Milan‐Bicocca Milan Italy
- Roberto Pontremoli
- Department of Internal Medicine University of Genoa, and Policlinico San Martino Genoa Italy
- Fosca Quarti‐Trevano
- Department of Medicine and Surgery University of Milano‐Bicocca Monza Italy
- Marcello Rattazzi
- Department of Medicine Università degli Studi di Padova Via Giustiniani 8 Padua 35128 Italy
- Gianpaolo Reboldi
- Department of Medical and Surgical Science University of Perugia Italy
- Giulia Rivasi
- Department of Geriatric and Intensive Care Medicine Careggi Hospital and University of Florence Italy
- Elisa Russo
- Department of Internal Medicine University of Genoa, and Policlinico San Martino Genoa Italy
- Massimo Salvetti
- Department of Clinical and Experimental Sciences University of Brescia Italy
- Pier Luigi Temporelli
- Division of Cardiac Rehabilitation Istituti Clinici Scientifici Maugeri, IRCCS, Gattico‐Veruno Italy
- Giuliano Tocci
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology University of Rome Sapienza, Sant’Andrea Hospital Rome Italy
- Andrea Ungar
- Department of Geriatric and Intensive Care Medicine Careggi Hospital and University of Florence Italy
- Paolo Verdecchia
- Hospital S. Maria della Misericordia Perugia Italy
- Francesca Viazzi
- Department of Internal Medicine University of Genoa, and Policlinico San Martino Genoa Italy
- Massimo Volpe
- Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology University of Rome Sapienza, Sant’Andrea Hospital Rome Italy
- Claudio Borghi
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department Alma Mater Studiorum University of Bologna Bologna Italy
- DOI
- https://doi.org/10.1161/JAHA.123.030319
- Journal volume & issue
-
Vol. 13,
no. 3
Abstract
Background Despite longstanding epidemiologic data on the association between increased serum triglycerides and cardiovascular events, the exact level at which risk begins to rise is unclear. The Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension has conceived a protocol aimed at searching for the prognostic cutoff value of triglycerides in predicting cardiovascular events in a large regional‐based Italian cohort. Methods and Results Among 14 189 subjects aged 18 to 95 years followed‐up for 11.2 (5.3–13.2) years, the prognostic cutoff value of triglycerides, able to discriminate combined cardiovascular events, was identified by means of receiver operating characteristic curve. The conventional (150 mg/dL) and the prognostic cutoff values of triglycerides were used as independent predictors in separate multivariable Cox regression models adjusted for age, sex, body mass index, total and high‐density lipoprotein cholesterol, serum uric acid, arterial hypertension, diabetes, chronic renal disease, smoking habit, and use of antihypertensive and lipid‐lowering drugs. During 139 375 person‐years of follow‐up, 1601 participants experienced cardiovascular events. Receiver operating characteristic curve showed that 89 mg/dL (95% CI, 75.8–103.3, sensitivity 76.6, specificity 34.1, P<0.0001) was the prognostic cutoff value for cardiovascular events. Both cutoff values of triglycerides, the conventional and the newly identified, were accepted as multivariate predictors in separate Cox analyses, the hazard ratios being 1.211 (95% CI, 1.063–1.378, P=0.004) and 1.150 (95% CI, 1.021–1.295, P=0.02), respectively. Conclusions Lower (89 mg/dL) than conventional (150 mg/dL) prognostic cutoff value of triglycerides for cardiovascular events does exist and is associated with increased cardiovascular risk in an Italian cohort.
Keywords
