The following is a summary of “Elevated LDL Triglycerides and Atherosclerotic Risk,” published in the January 2023 issue of Cardiology by Balling, et al.

There was no conclusive evidence linking increasing levels of low-density lipoprotein (LDL) triglycerides to a higher risk of atherosclerotic cardiovascular disease (ASCVD). The idea that higher LDL triglycerides were linked to an increased risk of ASCVD and each ASCVD component separately was investigated by researchers for a study.

The Copenhagen General Population Study was utilized by the study’s researchers to quantify the LDL triglycerides of 38,081 participants using a direct automated assay (direct LDL triglycerides) and 30,208 participants using nuclear magnetic resonance (NMR) spectroscopy (NMR LDL triglycerides). The current findings and previously published findings were combined in meta-analyses.

In the 2 cohorts, diagnoses of ASCVD were made in 872 and 5,766 people across median follow-ups of 3.0 and 9.2 years, respectively. The HRs for ASCVD was 1.26 (95% CI: 1.17-1.35), 1.27 (95% CI: 1.16-1.39) for ischemic heart disease, 1.28 (95% CI: 1.11-1.48) for myocardial infarction, 1.22 (95% CI: 1.08-1.38) for ischemic stroke, and 1.38 (95% CI: 1.21-1.58) for peripheral artery disease were each per 0.1 mmol/L (9 mg/dL) higher direct LDL triglycerides. HRs for NMR LDL triglycerides were 1.26 (95% CI: 1.20-1.33), 1.33 (95% CI: 1.25-1.41), 1.41 (95% CI: 1.31-1.52), 1.13 (95% CI: 1.05-1.23), and 1.26 (95% CI: 1.10-1.43), respectively. Apolipoprotein B levels couldn’t statistically account for all of the outcomes that were presented. For the highest quartile vs the lowest quartile of LDL triglycerides, random-effects risk ratios were 1.50 (95% CI: 1.35-1.66) for ASCVD (4 studies; 71,526 individuals; 8,576 events), 1.62 (95% CI: 1.37-1.93) for ischemic heart disease (6 studies; 107,538 individuals; 9,734 events), 1.30 (95% CI: 1.13-1.49) for ischemic stroke (4 studies; 78,026 individuals; 4,273 events), and 1.53 (95% CI: 1.29-1.81) for peripheral artery disease (4 studies; 107,511 individuals; 1,848 events).

In two prospective cohort studies, combined meta-analyses of prior and recent research, and each individual ASCVD component, elevated LDL triglycerides were strongly related to an increased risk of ASCVD and of each ASCVD component.

Reference: jacc.org/doi/10.1016/j.jacc.2022.10.019