Zafrir B, et al. - Due to the increase in metabolic risk factor, contributing causes and outcomes of severe to extreme hypertriglyceridemia (HTG) were investigated. A close association of HTG severity with cardiometabolic conditions was shown and a stepwise increase in the risk for pancreatitis was also noted, specifically when reduced triglyceride levels were not attained during follow-up. The risk for myocardial infarction, stroke or mortality may not be further increased by very-severe and extreme HTG, though mild-to-moderate HTG is a known established cardiovascular risk factor.

Methods

• Adverse outcomes were investigated in correlation to HTG severity by retrospectively analyzing regional database for subjects with severe HTG, with follow-up initiated at first documentation of HTG>1,000mg/dl.

Results

• This study included 3,091 subjects with severe (peak triglycerides 1,000-1,999 mg/dl; n=2,590), very-severe (2,000-2,999 mg/dl; n=369) and extreme (≥3,000 mg/dl; n=132) HTG, with mean age of 48±12 years; 73% males.
• Main contributing factors were obesity (48%) and diabetes (62%).
• Results of follow-up (median 101 months) revealed pancreatitis in 4.7%, myocardial infarction in 4.7% and stroke in 6%.
• The multivariate adjusted hazard ratio for pancreatitis was 3.22 (95%CI 2.21-4.70) for individuals with very-severe HTG and 5.55 (3.53-8.71) for those with extreme HTG, p<0.0001, relative to severe HTG, while the extent of HTG severity at these levels was not shown to be related to worse cardiovascular outcomes or death.
• Triglyceride levels <500 mg/dl were found to be associated with lower risk for developing pancreatitis but not myocardial infarction or stroke, and were achieved by most subjects (81%).