Abstract 4094: High Triglycerides, Low HDL Cholesterol, and Small LDL Particles are the Main Lipid Risk Factors In Coronary Patients With Type 2 Diabetes
Background: Data on the impact of serum lipids on the incidence of vascular events in coronary patients with type 2 diabetes mellitus (T2DM) are scarce. The aim of this study was to identify the lipid risk factors which most strongly predict vascular events in these patients.
Methods: We measured lipids and lipoproteins in fasting serum samples from 750 consecutive patients undergoing coronary angiography for the evaluation of suspected or established stable coronary artery disease. Prospectively, we recorded vascular events over 4 years.
Results: From our patients, 272 had a normal fasting glucose <100 mg/dl, 314 had an impaired fasting glucose ≥100 mg/dl, and 164 had T2DM. The incidence of vascular events significantly (p <0.001) increased from the group of patients with normal fasting glucose (14.7%) over the group of patients with impaired fasting glucose (19.4%) to the group of patients with T2DM (30.5%). In patients with T2DM, triglycerides (standardized adjusted hazard ratio = 1.192 [95% CI 1.035–1.373]; p = 0.015), and, inversely, HDL cholesterol (standardized adjusted hazard ratio = 0.657 [0.456– 0.948]; p = 0.025) and the LDL particle diameter (standardized adjusted hazard ratio = 0.747 [0.568–0.983]; p = 0.037), but not total cholesterol (p = 0.266), LDL cholesterol (p = 0.999), and apolipoprotein B (p = 0.296) were significantly predictive for the incidence of vascular events.
Conclusions: High Triglycerides, low HDL cholesterol, and small LDL particles are the main lipid risk factors for the incidence of vascular events among coronary patients with T2DM.