Frequency of residual combined dyslipidemia and hypertriglyceridemia in patients with coronary heart disease in 13 countries across 6 WHO Regions: results from INTERASPIRE

Background and aims: Hypertriglyceridemia (HTG) is independently associated with risk of atherosclerotic events, even when LDL-cholesterol levels appear controlled. This INTERASPIRE study determined the frequency of HTG and residual combined dyslipidemia and their related factors in patients with coronary heart disease (CHD) from 13 countries across six World Health Organization (WHO) regions. Methods: Participants with CHD underwent a standardized study interview and examination, including a centralized analysis of fasting blood samples. Elevated triglyceride (TG) and LDL-cholesterol were defined as ≥ 1.7 mmol/L and 1.8 mmol/L, respectively. Elevation in both was considered combined dyslipidemia. Results: Lipid profiles were available for 4069 patients. The mean age was 60.1 years (21.1 % women, 12.6 % smokers, 24 % obesity by body mass index [BMI], 61 % hypertension, and 44 % self-reported diabetes). Participants were evaluated 1.05 (0.76-1.45) years after their index CHD hospitalization. Overall, 12.7 % used no lipid-lowering therapies (LLT), 50.0 % used high-dose statins, and 11.8 % used combination therapies. Specific TG-lowering therapies were used by 2.3 %. One-third of patients had HTG, and 24.6 % had combined dyslipidemia. HTG was seen in all countries, but median TG values varied, with higher values among those not using LLT. HTG was independently associated with female sex, smoking, BMI, blood pressure, and LDL-cholesterol. HTG was inversely associated with HDL-cholesterol. Conclusions: HTG and residual combined dyslipidemia are common, although with wide variability between countries. A healthier lifestyle, weight reduction, greater use of combination therapy, and evidence-based TG-lowering treatments are necessary to reduce the risks of HTG and combined dyslipidemia.