BMC Medicine (Nov 2024)
Triglyceride-lowering therapies in hypertriglyceridemia-associated acute pancreatitis in China: a multicentre prospective cohort study
- Jing Zhou,
- Zuozheng Wang,
- Qinghong Liu,
- Longxiang Cao,
- Enrique de-Madaria,
- Gabriele Capurso,
- Christian Stoppe,
- Dong Wu,
- Wei Huang,
- Yingjie Chen,
- Siyao Liu,
- Donghuang Hong,
- Yun Sun,
- Zhenguo Zeng,
- Kaixiu Qin,
- Haibin Ni,
- Yi Sun,
- Yue Long,
- Feng Guo,
- Xiaofeng Liu,
- Xisheng Zheng,
- Guoxiu Zhang,
- Xiangcheng Zhang,
- Kai Zhou,
- Yizhe Chen,
- Qinghai Jiao,
- Xinsen Zou,
- Xiang Luo,
- Gang Li,
- Bo Ye,
- Chao Li,
- Lanting Wang,
- Shuai Li,
- John Windsor,
- Yuxiu Liu,
- Zhihui Tong,
- Weiqin Li,
- Lu Ke,
- for the Chinese Acute Pancreatitis Clinical Trials Group (CAPCTG)
Affiliations
- Jing Zhou
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University
- Zuozheng Wang
- Department of Hepatobiliary Surgery, General Hospital of Ningxia Medical University
- Qinghong Liu
- Department of Emergency, GanZhou People’s Hospital, Nanchang University
- Longxiang Cao
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University
- Enrique de-Madaria
- Department of Gastroenterology, Dr. Balmis, General University Hospital-ISABIAL
- Gabriele Capurso
- Pancreato-Biliary Endoscopy and Endosonography Division, Clinical Research Centre, Pancreas Translational, and, San Raffaele Scientific Institute IRCCS, Vita Salute San Raffaele University
- Christian Stoppe
- Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg
- Dong Wu
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
- Wei Huang
- Centre of Excellence for Pancreatitis, Institute of Integrated Traditional Chinese and Western Medicine, West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University
- Yingjie Chen
- Department of Critical Care Medicine, Hospital of Chengdu University of Traditional Chinese Medicine
- Siyao Liu
- Department of Emergency Medicine, The First Affiliated Hospital of Xiamen University
- Donghuang Hong
- Department of Critical Care Medicine, Fujian Provincial Hospital
- Yun Sun
- The First Department of Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical University
- Zhenguo Zeng
- Department of Critical Care Medicine, Medical Centre of Anesthesiology and Pain, The First Affiliated Hospital of Nanchang University
- Kaixiu Qin
- Department of Emergency Medicine, The Second Affiliated Hospital of Chongqing Medical University
- Haibin Ni
- Department of Emergency Medicine, Jiangsu Provincial Hospital of Integrated Chinese and Western Medicine
- Yi Sun
- The Fourth Department of the Digestive Disease Centre, Suining Central Hospital
- Yue Long
- Department of Critical Care Medicine, Qian Xi Nan People’s Hospital, Zunyi Medical University
- Feng Guo
- Department of Intensive Care Unit, Sir Run Run Shaw Hospital of Zhejiang University School of Medicine
- Xiaofeng Liu
- Department of Critical Care Medicine, The First Affiliated Hospital of Gannan Medical University
- Xisheng Zheng
- Department of Critical Care Medicine, Nanyang Central Hospital
- Guoxiu Zhang
- Department of Emergency Medicine, The First Affiliated Hospital and College of Clinical Medicineof , Henan University of Science and Technology
- Xiangcheng Zhang
- Department of ICU, The Affiliated Huaian No. 1, People’s Hospital of Nanjing Medical University
- Kai Zhou
- Department of Emergency, Medical Centre Hospital of Qionglai City
- Yizhe Chen
- Department of Critical Care Medicine, The Affiliated Wuxi People’s Hospital of Nanjing Medical University
- Qinghai Jiao
- Department of Critical Care Medicine, The First Hospital of HanDan
- Xinsen Zou
- Department of Critical Care Medicine, Bishan Hospital of Chongqing Medical University
- Xiang Luo
- Department of Critical Care Medicine, Longyan First Affiliated Hospital of Fujian Medical University
- Gang Li
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University
- Bo Ye
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University
- Chao Li
- Department of Epidemiology and Health Statistics, School of Public Health, Jiaotong University Health Science Centre
- Lanting Wang
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University
- Shuai Li
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University
- John Windsor
- Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, University of Auckland
- Yuxiu Liu
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University
- Zhihui Tong
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University
- Weiqin Li
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University
- Lu Ke
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University
- for the Chinese Acute Pancreatitis Clinical Trials Group (CAPCTG)
- DOI
- https://doi.org/10.1186/s12916-024-03755-8
- Journal volume & issue
-
Vol. 22,
no. 1
pp. 1 – 11
Abstract
Abstract Background No specific triglyceride-lowering therapy is recommended in patients with hypertriglyceridemia-associated acute pancreatitis (HTG-AP), primarily because of the lack of quality evidence. This study aimed to describe practice variations in triglyceride-lowering therapies for early HTG-AP patients and assess whether more rapid triglyceride decline is associated with improving organ failure. Methods This is a multicentre, prospective cohort study recruiting HTG-AP patients with elevated plasma triglyceride (> 11.3 mmol/L) admitted within 72 h from the onset of symptoms. Patients were dichotomised on study day 3 into either target reaching (plasma triglyceride ≤ 5.65 mmol/L) or not. The primary outcome was organ failure-free days (OFFD) to 14 days of enrolment. The association between target-reaching and OFFD was modelled. Additionally, the slope in plasma triglyceride over the first three days in response to treatment was calculated, and its association with OFFD was assessed as a sensitivity analysis. Results Among the 300 enrolled patients, 211 underwent exclusive medical treatment, and 89 underwent various blood purification therapies. Triglyceride levels were available in 230 patients on study day 3, among whom 122 (53.0%) had triglyceride levels of ≤ 5.65 mmol/l. The OFFD was not different between these patients and those in whom plasma triglyceride remained > 5.65 mmol/L [median (IQR): 13 (10–14) vs. 14 (10–14), p = 0.46], even after adjustment for potential confounders. For the decline slopes, there was no significant change in OFFD with a steeper decline slope [risk difference, − 0.088, 95% CI, − 0.334 to 0.158, p = 0.48]. Conclusions Triglyceride-lowering therapies vary greatly across centres. More rapid triglyceride decline was not associated with improving incidence and duration of organ failure.
Keywords
