In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.


The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Prospective study of fasting and postprandial chylomicron triglyceride content and cardiovascular events in patients with stable coronary artery disease

Session Poster session 2

Speaker Christian Werner

Congress : ESC Congress 2017

  • Topic : preventive cardiology
  • Sub-topic : Lipids
  • Session type : Poster Session
  • FP Number : P1510

Authors : C Werner (Homburg,DE), T Stojakovic (Graz,AT), W Maerz (Graz,AT), H Scharnagl (Graz,AT), U Laufs (Graz,AT)

Authors:
C. Werner1 , T. Stojakovic2 , W. Maerz2 , H. Scharnagl2 , U. Laufs2 , 1Universitätsklinikum des Saarlandes - Klinik für Innere Medizin III - Homburg - Germany , 2Medical University of Graz, Klinisches Institut für Medizinische und Chemische Labordiagnostik - Graz - Austria ,

Citation:
European Heart Journal ( 2017 ) 38 ( Supplement ), 313

Aims: The association of triglyceride (TG) concentrations and cardiovascular risk in patients with cardiovascular disease remains to be fully understood. We performed a detailed lipid characterization and tested the association of fasting and postprandial lipoprotein composition and event-free survival in patients with coronary artery disease (CAD).

Methods: 195 patients with stable CAD on guideline-recommended cardiovascular medication were prospectively enrolled in the study, underwent a standardized oral triglyceride tolerance test (OTT) and were followed up for 4 years. Fasting and 5 hours (5h) postprandial plasma was subjected to serial ultracentrifugation and precipitation techniques to differentiate lipoprotein subclasses and to determine TG, cholesterol, phospholipids and apolipoproteins in chylomicrons, very low-density, low-density and high-density lipoproteins. TG/apoB ratios were calculated to indicate chylomicron particle size and TG content.

Results: The OTT induced a TG increase from 151±96 to 265±161 mg/dl after 5h (mean±SD). Cholesterol parameters and apolipoproteins A1, A2, B, C2, C3 and E remained unchanged. The postprandial TG increase was attributable to the increase of chylomicron-TG (0h: 80±83mg/dl, 5h: 181±140mg/dl; mean individual increase 313±261%). VLDL-TG increased from 12.5±12.7 to 17.9±14.6mg/dl and LDL- and HDL-TG remained unchanged. The chylomicron TG/apoB ratio increased from 3.3±2.8 to 8.4±9.2 after the OTT. Associations of lipoproteins and events were determined by Kaplan-Meier and Cox regression analyses. 97 patients experienced a primary endpoint (death, myocardial infarction, unplanned revascularization) during follow-up. Patients with events had a higher chylomicron TG/apoB ratio. After adjustment, both fasting and postprandial chylomicron TG/apoB ratios were associated with outcomes (per SD, log-values: fasting: HR 1.52 (CI 1.13–2.05), p=0.006; postprandial: HR 1.25 (CI 1.01–1.55), p=0.044), adjusted for age, gender, medication, risk factors, LDL and HDL). The TG/apoB index correlated with fasting TG concentrations (R=0.58). Only the fasting chylomicron TG/apoB index remained predictive for events after full adjustment including fasting TG (HR 1.47 (CI 1.03–2.09), p=0.034), but risk prediction by postprandial TG/apoB ratio was attenuated after adjustment for fasting TG.

Conclusions: The results of the detailed lipid characterization in CAD patients show no advantage of a postprandial compared to a fasting measurement. Importantly, elevated fasting chylomicron triglycerides identify CAD patients at higher risk for cardiovascular events.



Based on your interests

Members get more

Join now
  • 1ESC Professional Members – access all resources from ESC Congress and ESC Asia with APSC & AFC
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s congress resources
  • 3Under 40 or in training - with a Combined Membership, access resources from all congresses
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are