Abstract 859: Nonfasting Cholesterol and Triglycerides, Myocardial Infarction, and Total Mortality
Background: Current guidelines recommend identification and treatment of elevated cholesterol levels, but not of nonfasting triglycerides. We compared the ability of these lipids to predict risk of myocardial infarction and total mortality.
Methods: We followed 7581 women and 6391 men from the Danish general population for 31 years.
Results: Among women, 768 developed myocardial infarction and 4398 died; corresponding numbers in men were 1151 and 4416. Compared to women with cholesterol <5mmol/L, multivariate adjusted hazard ratios for myocardial infarction ranged from 1.3(95%CI 0.9 –1.8) for cholesterol of 5–5.99 mmol/L to 2.5 (1.6 – 4.0) for cholesterol ≥9mmol/L (trend p<0.0001), while compared with women with nonfasting triglycerides <1 mmol/L, hazard ratios ranged from 1.5 (1.2–1.8) for triglycerides of 1–1.99 mmol/L to 4.2(2.5–7.2) for triglycerides ≥5mmol/L (p<0.0001). In men, corresponding hazard ratios ranged from 1.2 (1.0 –1.5) to 5.3 (3.6 – 8.0) for cholesterol (p<0.0001), and from 1.3(1.0 –1.6) to 2.1 (1.5–2.8) for triglycerides (p<0.0001). Increasing cholesterol levels did not consistently associate with total mortality in women (trend p=0.39) or men (p=0.02). In contrast, compared with women with triglycerides <1 mmol/L, multivariate adjusted hazard ratios for total mortality ranged from 1.1 (1.0 –1.2) for triglycerides of 1–1.99 mmol/L to 2.0(1.5–2.9) for triglycerides ≥5mmol/L (trend p<0.0001); corresponding hazard ratios in men ranged from 1.1(1.0 –1.2) to 1.5(1.2–1.7) (p<0.0001).
Conclusion: Stepwise increasing levels of both nonfasting cholesterol and nonfasting triglycerides associate with stepwise increasing risk of myocardial infarction; however, only increasing levels of nonfasting triglycerides associate with total mortality.