Physicians' Academy for Cardiovascular Education

Higher nonfasting triglycerides increase the risk of heart failure

Nonfasting Triglycerides, Low-Density Lipoprotein Cholesterol, and Heart Failure Risk: Two Cohort Studies of 113 554 Individuals

Literature - Varbo A and Nordestgaard BG. - ATVB 2018; published online ahead of print


There are strong associations between high concentrations of nonfasting TGs and risk of ischemic stroke, MI, ischemic heart disease (IHD), and all-cause mortality [1,2], as well as between TGs, diabetes and HF [3,4]. Hence, high concentrations of nonfasting TGs might also be associated with HF, although existing data have led to conflicting results [5-7].

In this study, it was evaluated whether high concentrations of nonfasting TGs and LDL-c are associated with a higher risk of HF in the general population. For this purpose 103 860 individuals with 2146 cases of HF from the Copenhagen General Population Study (2003–2014) were included, and the results were confirmed in the Copenhagen City Heart Study with 9694 individuals and 1447 cases of HF (1991–1994) and with minimal use of statins.

Individuals were divided into groups by their concentrations of nonfasting triglycerides and LDL-c, based on clinically meaningful cut points and without excluding extremely high concentrations, since they represent theoretically the highest risk of HF.

Main results


Stepwise higher concentrations of nonfasting TGs were associated with stepwise higher risk of HF, which was not the case for LDL-c. These findings support the need for further investigations examining whether TG and remnant cholesterol lowering in those with high concentrations would lower the HF risk.


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