학술논문
Prognostic Value and Relative Cutoffs of Triglycerides Predicting Cardiovascular Outcome in a Large Regional-Based Italian Database.
Document Type
Academic Journal
Author
Tikhonoff V; Department of Medicine Università degli Studi di Padova Via Giustiniani 8 Padua 35128 Italy.; Casiglia E; Studium Patavinum, Department of Medicine Università degli Studi di Padova Padua Italy.; Virdis A; Department of Clinical and Experimental Medicine University of Pisa Italy.; Grassi G; Department of Medicine and Surgery University of Milano-Bicocca Monza Italy.; Angeli F; Department of Medicine and Surgery University of Insubria Varese Italy.; Arca M; Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy.; Barbagallo CM; Biomedical Department of Internal Medicine and Specialistics University of Palermo Italy.; Bombelli M; Department of Medicine and Surgery University of Milano-Bicocca Monza Italy.; Internal Medicine, Pio XI Hospital of Desio, ASST Brianza Desio Italy.; Cappelli F; Department of Clinical and Experimental Medicine University of Pisa Italy.; Cianci R; Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy.; Cicero AFG; Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department Alma Mater Studiorum University of Bologna Bologna Italy.; IRCCS AOU S.Orsola di Bologna Bologna Italy.; Cirillo M; Department of Medicine 'Scuola Medica Salernitana' University of Salerno Baronissi (SA) Italy.; Cirillo P; Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation 'Aldo Moro' University of Bari Bari Italy.; Dell'oro R; Department of Medicine and Surgery University of Milano-Bicocca Monza Italy.; D'elia L; Department of Clinical Medicine and Surgery 'Federico II' University of Naples Medical School Naples Italy.; Desideri G; Department of Life, Health and Environmental Sciences University of L'Aquila Italy.; Ferri C; Department of Life, Health and Environmental Sciences University of L'Aquila Italy.; Galletti F; Department of Clinical Medicine and Surgery 'Federico II' University of Naples Medical School Naples Italy.; Gesualdo L; Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation 'Aldo Moro' University of Bari Bari Italy.; Giannattasio C; Cardiology IV, 'A.De Gasperi's' Department Niguarda Ca' Granda Hospital Milan Italy.; School of Medicine and Surgery Milano-Bicocca University Milan Italy.; Iaccarino G; Department of Advanced Biomedical Sciences 'Federico II' University of Naples Naples Italy.; Mallamaci F; CNR-IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit Reggio Calabria Italy.; Maloberti A; Cardiology IV, 'A.De Gasperi's' Department Niguarda Ca' Granda Hospital Milan Italy.; School of Medicine and Surgery Milano-Bicocca University Milan Italy.; Masi S; Department of Clinical and Experimental Medicine University of Pisa Italy.; Masulli M; Department of Clinical Medicine and Surgery 'Federico II' University of Naples Medical School Naples Italy.; Mazza A; Department of Internal Medicine Santa Maria della Misericordia General Hospital, AULSS 5 Polesana Rovigo Italy.; Mengozzi A; Department of Clinical and Experimental Medicine University of Pisa Italy.; Muiesan ML; Department of Clinical and Experimental Sciences University of Brescia Italy.; Nazzaro P; Department of Medical Basic Sciences, Neurosciences and Sense Organs University of Bari Medical School Bari Italy.; Palatini P; Studium Patavinum, Department of Medicine Università degli Studi di Padova Padua Italy.; Parati G; S. Luca Hospital Istituto Auxologico Italiano and University of Milan-Bicocca Milan Italy.; Pontremoli R; Department of Internal Medicine University of Genoa, and Policlinico San Martino Genoa Italy.; Quarti-Trevano F; Department of Medicine and Surgery University of Milano-Bicocca Monza Italy.; Rattazzi M; Department of Medicine Università degli Studi di Padova Via Giustiniani 8 Padua 35128 Italy.; Medicina Interna I Ca' Foncello University Hospital Treviso Italy.; Reboldi G; Department of Medical and Surgical Science University of Perugia Italy.; Rivasi G; Department of Geriatric and Intensive Care Medicine Careggi Hospital and University of Florence Italy.; Russo E; Department of Internal Medicine University of Genoa, and Policlinico San Martino Genoa Italy.; Salvetti M; Department of Clinical and Experimental Sciences University of Brescia Italy.; Temporelli PL; Division of Cardiac Rehabilitation Istituti Clinici Scientifici Maugeri, IRCCS, Gattico-Veruno Italy.; Tocci G; Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology University of Rome Sapienza, Sant'Andrea Hospital Rome Italy.; Ungar A; Department of Geriatric and Intensive Care Medicine Careggi Hospital and University of Florence Italy.; Verdecchia P; Hospital S. Maria della Misericordia Perugia Italy.; Viazzi F; Department of Internal Medicine University of Genoa, and Policlinico San Martino Genoa Italy.; Volpe M; Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology University of Rome Sapienza, Sant'Andrea Hospital Rome Italy.; IRCCS San Raffaele Rome Rome Italy.; Borghi C; Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department Alma Mater Studiorum University of Bologna Bologna Italy.; IRCCS AOU S.Orsola di Bologna Bologna Italy.
Source
Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Despite longstanding epidemiologic data on the association between increased serum triglycerides and cardiovascular events, the exact level at which risk begins to rise is unclear. The Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension has conceived a protocol aimed at searching for the prognostic cutoff value of triglycerides in predicting cardiovascular events in a large regional-based Italian cohort.
Methods and Results: Among 14 189 subjects aged 18 to 95 years followed-up for 11.2 (5.3-13.2) years, the prognostic cutoff value of triglycerides, able to discriminate combined cardiovascular events, was identified by means of receiver operating characteristic curve. The conventional (150 mg/dL) and the prognostic cutoff values of triglycerides were used as independent predictors in separate multivariable Cox regression models adjusted for age, sex, body mass index, total and high-density lipoprotein cholesterol, serum uric acid, arterial hypertension, diabetes, chronic renal disease, smoking habit, and use of antihypertensive and lipid-lowering drugs. During 139 375 person-years of follow-up, 1601 participants experienced cardiovascular events. Receiver operating characteristic curve showed that 89 mg/dL (95% CI, 75.8-103.3, sensitivity 76.6, specificity 34.1, P <0.0001) was the prognostic cutoff value for cardiovascular events. Both cutoff values of triglycerides, the conventional and the newly identified, were accepted as multivariate predictors in separate Cox analyses, the hazard ratios being 1.211 (95% CI, 1.063-1.378, P =0.004) and 1.150 (95% CI, 1.021-1.295, P =0.02), respectively.
Conclusions: Lower (89 mg/dL) than conventional (150 mg/dL) prognostic cutoff value of triglycerides for cardiovascular events does exist and is associated with increased cardiovascular risk in an Italian cohort.
Methods and Results: Among 14 189 subjects aged 18 to 95 years followed-up for 11.2 (5.3-13.2) years, the prognostic cutoff value of triglycerides, able to discriminate combined cardiovascular events, was identified by means of receiver operating characteristic curve. The conventional (150 mg/dL) and the prognostic cutoff values of triglycerides were used as independent predictors in separate multivariable Cox regression models adjusted for age, sex, body mass index, total and high-density lipoprotein cholesterol, serum uric acid, arterial hypertension, diabetes, chronic renal disease, smoking habit, and use of antihypertensive and lipid-lowering drugs. During 139 375 person-years of follow-up, 1601 participants experienced cardiovascular events. Receiver operating characteristic curve showed that 89 mg/dL (95% CI, 75.8-103.3, sensitivity 76.6, specificity 34.1, P <0.0001) was the prognostic cutoff value for cardiovascular events. Both cutoff values of triglycerides, the conventional and the newly identified, were accepted as multivariate predictors in separate Cox analyses, the hazard ratios being 1.211 (95% CI, 1.063-1.378, P =0.004) and 1.150 (95% CI, 1.021-1.295, P =0.02), respectively.
Conclusions: Lower (89 mg/dL) than conventional (150 mg/dL) prognostic cutoff value of triglycerides for cardiovascular events does exist and is associated with increased cardiovascular risk in an Italian cohort.