Nonfasting Triglycerides and Risk of Myocardial Infarction, Ischemic Heart Disease, and Death in Men and Women

Abstract

Hypertriglyceridemia is a heterogeneous disorder with an unclear association with atherosclerosis.^1-4 Patients with high triglyceride levels of more than 25 mmol/L (>2212.4 mg/dL) and the familial chylomicronemia syndrome rarely develop atherosclerosis,⁴ perhaps because their plasma lipoprotein particles are too large to enter into the arterial intima.^5,6 However, patients with moderate hypertriglyceridemia and conditions like familial hypertriglyceridemia, familial combined hyperlipidemia, the metabolic syndrome, and remnant hyperlipidemia often develop premature atherosclerosis.^1-4 With moderate hypertriglyceridemia, chylomicron remnants and very low-density lipoprotein remnants are present in plasma. These smaller triglyceride-rich lipoproteins penetrate the arterial intima⁷ and appear to be preferentially trapped within the arterial wall.^8,9