Low admission triglyceride and mortality in acute coronary syndrome patients

Abstract

BACKGROUND: The relationship between admission triglyceride (TG) levels and long-term
outcomes has not been established in patients with acute coronary syndrome. We tested the
hypothesis that patients who develop non-ST segment elevation myocardial infarction
(NSTEMI) despite low TG have a worse cardiovascular outcome in the long term.

METHODS: Patients admitted with NSTEMI between 1 January 1997 and 31 December 2000
and with fasting lipid profiles measured within 24 hours of admission were included for
analysis. Baseline characteristics and three-year all-cause mortality were compared between
the patients with TG above and below the median. Multivariate analysis was used to determine
the predictors of all-cause mortality and adjusted survival was analyzed using the Cox
proportional hazard model.

RESULTS: Of 517 patients, 395 had TG £ 200 mg/dL and 124 had TG > 200 mg/dL. Patients
with low TG were more often Caucasian, with no significant differences in gender or severity
of coronary artery disease between the two groups. There was a trend for increased all-cause
mortality at six months (9% vs 3%, p = 0.045) and three years (13.4% vs 5.6%, p = 0.016) in
patients with low TG. In multivariate analysis, low TG level at admission was an independent
predictor of increased mortality at three years (adjusted OR 2.5, 95% CI = 1.04–5.9, p = 0.04).

CONCLUSIONS: In our cohort, lower TG at admission is associated with increased three-year
mortality in patients with NSTEMI. Whether this is a result of current therapy, or a marker
for worse baseline characteristics, needs to be studied further. (Cardiol J 2011; 18, 3: 297–303)