Triglyceride levels and its association with all-cause mortality and cardiovascular outcomes among patients with heart failure
Qing-Wen Ren, Tiew‐Hwa Katherine Teng, Wouter Ouwerkerk, Yi-Kei Tse, Christopher Tze‐Wei Tsang, Mei‐Zhen Wu, Hung‐Fat Tse, Adriaan A. Voors, Jasper Tromp, Carolyn S.P. Lam, Kai Hang Yiu
Abstract
Remnant cholesterol, identified by triglyceride-rich lipoprotein, is a significant causal risk factor for ischemic heart diseases. The association of triglyceride levels with all-cause and cause-specific outcomes in heart failure (HF) remains unexplored. Using a previously validated territory-wide clinical information registry, all eligible patients diagnosed with HF (N = 127124) from 2000 to 2020 were included. In this population-based cohort (mean age: 71.4 ± 12.2 years, 51.8% male), the association between triglyceride levels and risk of all-cause mortality and cardiovascular disease was a U-shapedḍ curve. High triglyceride levels (≥3.0 mmol/L) were associated with atherosclerotic cardiovascular disease admission or death; conversely, lower triglyceride levels (<1.2 mmol/L) were associated with higher risks of HF readmission or death. The risk of adjusted all-cause mortality reached a nadir between triglyceride levels of 1.2 mmol/L and 3.0 mmol/L. Results were externally validated in BIOSTAT-CHF. Our findings have important implications for defining the role of triglyceride levels in contributing to the diverse outcomes in patients with HF. The association between triglyceride (TG) and mortality remains controversial in individuals with heart failure (HF). Here the authors show a U-shaped association where high TG levels are associated with ASCVD-related admission or death and lower TG levels are associated with HF-related readmission or death.