Association of Lipids With Incident Heart Failure Among Adults With and Without Diabetes Mellitus
Year: 2013
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Dyslipidemia is a known risk factor for coronary disease, but its role in heart failure (HF) development is less well-defined. METHODS AND RESULTS: We included 5688 participants, aged 45 to 84 years, without clinical cardiovascular disease, and not receiving lipid-lowering medications at baseline, from the Multiethnic Study of Atherosclerosis. Cox-proportional hazards models were used to evaluate associations of triglyceride, total cholesterol/high-density lipoprotein-cholesterol (HDL-C) ratio, HDL-C, and non HDL-C with incident HF. We investigated for effect-modification by diabetes mellitus status and sex. During a median follow-up of 8.5 years, there were 152 incident HF cases. There were no interactions by sex. We observed significant interactions between triglyceride and diabetes mellitus (P(interaction)<0.05). We stratified our analyses by diabetes mellitus status. In participants with diabetes, the hazard ratios were 2.03 (0.97-4.27) and 1.68 (1.18-2.38) for high triglyceride and log of triglyceride, respectively, after adjusting for confounders, comorbidities, and diabetes mellitus severity/treatment. The association of high triglyceride with incident HF was attenuated by interim myocardial infarction. The hazard ratios were greatest in participants with diabetes who also had high triglyceride, low HDL-C, or high total cholesterol/HDL-C ratio (3.59 [2.03-6.33], 3.62 [2.06-6.36], and 3.54 [1.87-6.70], respectively). Lipid measures were not associated with incident HF in individuals without diabetes. CONCLUSIONS: The risk of incident HF is greater in individuals with diabetes mellitus who also have high triglyceride, low HDL-C, or high total cholesterol/HDL-C ratio. The association of high triglyceride with incident HF is partly mediated by myocardial infarction.
Source: Circulation Heart Failure
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1261793039, MESA, G1276754516, G1409423729, Training Grant in Quality of Care and Outcomes Research in Cardiovascular Disease, G1640378483, G2144938473, G22458031, MESA, MESA, G2837638605, G290884426, G291913881, SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--EBCT READING, G3342651296, G3647016462, MESA, TITLE: MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA), OPTION 3. 4/1/2014 - 3/31/2015. MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA) - READING CENTER, NHLBI, MESA, SUBCLINICAL CARDIOVASCULAR DISEASE STUDY-ULTRASOUND, MESA, G66341962, MESA, G78770644, G991334795
OpenAlex ID: W2160079867