Frequency of residual combined dyslipidemia and hypertriglyceridemia in patients with coronary heart disease in 13 countries across 6 WHO Regions: Results from INTERASPIRE
- PMID: 40315644
- DOI: 10.1016/j.atherosclerosis.2025.119215
Frequency of residual combined dyslipidemia and hypertriglyceridemia in patients with coronary heart disease in 13 countries across 6 WHO Regions: Results from INTERASPIRE
Abstract
Background and aims: Hypertriglyceridemia (HTG) is independently associated with risk of atherosclerotic events, even when LDL-cholesterol levels appear controlled. This INTERASPIRE study determined the frequency of HTG and residual combined dyslipidemia and their related factors in patients with coronary heart disease (CHD) from 13 countries across six World Health Organization (WHO) regions.
Methods: Participants with CHD underwent a standardized study interview and examination, including a centralized analysis of fasting blood samples. Elevated triglyceride (TG) and LDL-cholesterol were defined as ≥ 1.7 mmol/L and 1.8 mmol/L, respectively. Elevation in both was considered combined dyslipidemia.
Results: Lipid profiles were available for 4069 patients. The mean age was 60.1 years (21.1 % women, 12.6 % smokers, 24 % obesity by body mass index [BMI], 61 % hypertension, and 44 % self-reported diabetes). Participants were evaluated 1.05 (0.76-1.45) years after their index CHD hospitalization. Overall, 12.7 % used no lipid-lowering therapies (LLT), 50.0 % used high-dose statins, and 11.8 % used combination therapies. Specific TG-lowering therapies were used by 2.3 %. One-third of patients had HTG, and 24.6 % had combined dyslipidemia. HTG was seen in all countries, but median TG values varied, with higher values among those not using LLT. HTG was independently associated with female sex, smoking, BMI, blood pressure, and LDL-cholesterol. HTG was inversely associated with HDL-cholesterol.
Conclusions: HTG and residual combined dyslipidemia are common, although with wide variability between countries. A healthier lifestyle, weight reduction, greater use of combination therapy, and evidence-based TG-lowering treatments are necessary to reduce the risks of HTG and combined dyslipidemia.
Keywords: Combined dyslipidemia; Coronary heart disease; Female sex; Obesity; Smoking; Statins; Triglycerides.
Copyright © 2025 Elsevier B.V. All rights reserved.
Conflict of interest statement
Conflicts of interest declaration: RDS reports consultancies, talks, and research sponsored by Aché, Amgen, Amryt, Arrowhead, Daiichi-Sankyo, Eli-Lilly, Esperion, Ionis, Kowa, Libbs, MSD, Novartis, Novo Nordisk, PTC Therapeutics, Torrent, Ultragenyx, and Sanofi/Regeneron; KKR has received research grants from Amgen, Daiichi Sankyo, Merck Sharp & Dohme, Regeneron, Pfizer, and Sanofi and is consultant for Abbott, Amarin, Amgen, Astra Zeneca, Bayer, Biologixpharma, Boehringer Ingelheim, Cargene, CRISPR, CSL Behring, Eli Lilly, and Company, Esperion, Kowa, New Amsterdam, Novartis, Novo Nordisk, Pfizer, Regeneron, Resverlogix, Sanofi, SCRIBE, Silence Therapeutics, VAXXINITY, and Viatris and stock options New Amsterdam Pharma, Pemi 31, SCRIBE Therapeutics; GYHL is a National Institute for Health and Care Research (NIHR) Senior Investigator; he is a consultant and speaker for BMS/Pfizer, Boehringer Ingelheim, Daiichi-Sankyo, Anthos (No fees are received personally); PJ has received research grants and remuneration for lectures and consultancy from Amgen, Novartis, Polpharma, Sanofi, Servier, and Zentiva; A.A. has received a grant from SPC for laboratory testing for this study in Portugal and honoraria from Ferrer and Daiichi Sankyo; JT has received honoraria from AstraZeneca, Amgen, Boston Scientific, Medtronic, Boehringer Ingelheim, Roche Diagnostics, Novartis and is a consultant for Johnson& Johnson and Medtronic; A.A. has received a grant from SPC for laboratory testing for this study in Portugal and honoraria from Ferrer and Daiichi Sankyo. D.W. has received research grants from the European Atherosclerosis Society, European Society of Cardiology, International Atherosclerosis Society, Novartis, Pfizer, Sanofi, and Viatris to the National Institute for Prevention and Cardiovascular Health. PL is an unpaid consultant to, or involved in clinical trials for Amgen, Baim Institute, Beren Therapeutics, Esperion Therapeutics, Genentech, Kancera, Kowa Pharmaceuticals, Novo Nordisk, Novartis, and Sanofi-Regeneron. PL is a member of the scientific advisory board for Amgen, Caristo Diagnostics, CSL Behring, Elucid Bioimaging, Kancera, Kowa Pharmaceuticals, Olatec Therapeutics, Novartis, PlaqueTec, Polygon Therapeutics, TenSixteen Bio, Soley Thereapeutics, and XBiotech, Inc. PL’s laboratory has received research funding in the last 2 years from Novartis, Novo Nordisk, and Genentech. PL is on the Board of Directors of XBiotech, Inc. PL has a financial interest in Xbiotech, a company developing therapeutic human antibodies, in TenSixteen Bio, a company targeting somatic mosaicism and clonal hematopoiesis of indeterminate potential (CHIP) to discover and develop novel therapeutics to treat age-related diseases, and in Soley Therapeutics, a biotechnology company that is combining artificial intelligence with molecular and cellular response detection for discovering and developing new drugs, currently focusing on cancer therapeutics. PL’s interests were reviewed and are managed by Brigham and Women’s Hospital and Mass General Brigham in accordance with their conflict- of-interest policies. All other authors have none to declare.
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