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What should we do about Hypertriglyceridemia in Coronary Artery Disease Patients?

  • Coronary Artery Disease (PG Steg, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Opinion statement

Triglycerides are routinely obtained with standard lipid testing, but their role in cardiovascular risk is controversial. An excess of triglycerides is commonly encountered in patients with the metabolic syndrome or diabetes, and represents an excess burden of small, dense low-density lipoproteins (LDLs), which confers additive risk for cardiovascular disease. Current guidelines prioritize LDL targets first, but treatment of triglycerides once LDL targets are achieved bears consideration. Beyond lifestyle modification, potential pharmacologic therapies include statins, fibrates, niacin, omega-3 fatty acids and antidiabetic drugs. There are few trials to date comparing these agents directly in the management of hypertriglyceridemia, but available data seems to demonstrate that the greatest benefit of triglyceride lowering is experienced in a subgroup of patients with an atherogenic lipid profile (elevated triglycerides, low high-density lipoprotein (HDL), elevated small, dense LDL particles). Here, we discuss the current understanding of how triglyceride elevations impart cardiovascular risk, current therapies and the data supporting their use, and ongoing studies to elucidate the degree to which treatment of triglycerides modifies risk of future cardiovascular events.

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Disclosures

J. Berger: none; E. Gianos: consultancy for Amarin; A. Singh: none; A. Schwartzbard: payment for development of educational presentations from Takeda, Merck, and Gilead; H. Weintraub: consultancy for Abbott Pharma, Payment for development of educational presentations for Abbott, AstraZeneca, Kowa, Takeda, Daiichi Sankyo, Boehringer, Novartis, travel/accommodations expenses covered or reimbursed by Amarin Corporation.

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  1. Division of Cardiology, NYU Langone Medical Center, New York, NY, United States

    Amita Singh MD, Arthur Schwartzbard MD, Eugenia Gianos MD, Jeffrey S. Berger MD & Howard Weintraub MD

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  1. Amita Singh MD
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  2. Arthur Schwartzbard MD
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  3. Eugenia Gianos MD
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Correspondence to Howard Weintraub MD.

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Singh, A., Schwartzbard, A., Gianos, E. et al. What should we do about Hypertriglyceridemia in Coronary Artery Disease Patients?. Curr Treat Options Cardio Med 15, 104–117 (2013). https://doi.org/10.1007/s11936-012-0220-7

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