Background
Methods
Eligibility criteria
Study identification and data extraction
Quality
Statistical analysis
Subgroup analyses and publication bias
Results
Search results and included studies
Methodological quality and risk of bias
Study Label | Design | Objective of Study | Population | Age (mean) | Sample Size | Length of Follow-up | Definition of CV events |
---|---|---|---|---|---|---|---|
Acarturk, 2004[13] | Prospective cohort | to investigate the relation between age and gender differences in plasma TG and CAD in patients with angiographically proven CAD | patients admitted for diagnostic coronary angiography due to chest pain | 54.9 +/-10.26 | 937 | NR | Coronary artery disease |
Bansal, 2007[14] | Prospective cohort | To determine the association of triglyceride levels (fasting vs nonfasting) and risk of future cardiovascular events. | healthy women | 54.2 +/- 7.06 | 26,509 | 136.8 Months (median) | composite of confirmed nonfatal MI, nonfatal ischemic stroke, coronary revascularization, or death due to cardiovascular causes |
Barrett-Connor, 1987[15] | Prospective cohort | To examine the independent effect of triglyceride on the prediction of cardiovascular disease after the effects of cholesterol and other heart disease risk factors have been accounted for | healthy fasting men without known CVD | 57.7 | 1,589 | 144 months | N/A |
Bass, 1993[16] | Prospective cohort | To further explore the relationships between lipid and lipoprotein levels and other conventional CVD risk factors and CVD death on women | women 30 years of age and older | 58.2 +/- 5.5 | 1,405 | Mean 168 months | N/A |
Bonaventure, 2010[17] | Prospective cohort | To find the association pattern between serum TG and incident intracerebral hemorrhage as compared with coronary events and ischemic stroke | Population- based, elderly participants free from institutionalization were recruited from the electoral rolls of three French cities | 74.03 years | 8,393 | mean of 5 years | MI, hospitalized angina pectoris, acute coronary syndrome, coronary endovascular dilatation, coronary bypass, or death due to a coronary event |
Carlson, 1988[18] | RCT | To obtain a pronounced serum lipid lowering by combined use of clofibrate and nicotinic acid in an effort to reduce the risk of IHD | Survivors of MI < 70 years of age | 58.9 + -0.4 males and 62.5 + -0.9 females | Control group (n = 276) | 60 months | N/A |
Chan, 2005[19] | Prospective cohort | To examine the lipid profiles in Chinese type 2 diabetic patients and their relationship with anthropometric parameters, glycemic control and cardiovascular mortality. | Chinese patients with type 2 DM | 54.0 +/- 14.0 | 517 | Mean 55.2 +/-10.8 months | N/A |
Chester, 1995[20] | Prospective cohort | To determine the standard clinical or angiographic variables or both present at initial angiography associated with the development of adverse coronary events in patients awaiting routine PTCA | Patients awaiting routine percutaneous transluminal coronary angioplasty (PTCA) | 57 | 215 | Median 8 months | fatal or non-fatal MI, unstable angina or angiographic new total coronary occlusion |
Czernichow, 2007[21] | Prospective cohort | To investigated the relationship of baseline 'hypertriglyceridemic waist' (HTGW) status with CVD risk in middle-aged French men | middle-aged French men, included diabetics | 51.9 +/- 4.7 | 3,430 | 90 months | new-onset angina, fatal and non-fatal MI or stroke, transient ischemic attack, sudden death or intermittent claudication |
Drexel, 2005[22] | Prospective cohort | To evaluate the atherogenicity of lipids in coronary patients with normal fasting glucose (NFG), impaired fasting glucose (IFG), and type 2 DM | Caucasian patients who were referred to coronary angiography | 62.4 +/- 10.6 | 750 | 27.6 +/- 4.8 months | N/A |
Eberly, 2003[23] | Prospective cohort | To determine whether HTG is an independent risk factor for coronary heart disease (CHD), and whether fasting and nonfasting triglyceride (TG) levels are equally predictive | men at increased risk but without clinical evidence of definite CHD at baseline | 46.3 | 2809 | 304.8 months | either a clinical MI or a significant serial electrocardiogram change indicative of MI |
Egger, 1999[24] | Prospective cohort | To assess the influence of differential precision in the measurement of the correlated variables total cholesterol and HDL cholesterol on estimates of risk of IHD associated with TG levels | Middle aged men living in the town of Caerphilly, South Wales, UK | 52.1 +/- 4.48 | 2,512 | 5 and 10 years after baseline | death from ischemic heart disease, clinical non-fatal MI, electrocardiographic MI |
Ellingsen, 2003[25] | Prospective cohort | to examine the effect of group assignment on IHD mortality in subjects with normal or high fasting TG | healthy men who had an elevated serum total cholesterol concentration or coronary risk score | 46 +/-3 | 1232 | 276 months | N/A |
Gaziano, 1997[26] | Case controlled study | To examine the interrelationships of the fasting TG level other lipid parameters and nonlipid risk factors with risk of MI. | Patients - coronary care and other intensive care units patients (no history of MI and angina pectoris) with whom symptoms of MI had begun 24 h of admission, control - residents of home towns. | 57.7 +/- 9.65 | 680 | NR | N/A |
Goldberg, 2009[27] | Prospective/ case controlled | To ascertain coronary artery disease outcomes and predictive factors in patients with SLE and matched healthy controls prospectively | Patients with systemic lupus erythematosus (SLE) and matched healthy controls | SLE cases 44.2 +/-12.2, controls 44.5 +/- 4.4 | 237 controls and 241 SLE cases | 86.4 months | Defined as the occurrence of MI and/or angina pectoris due to atherosclerosis. |
Habib, 2006[28] | Prospective cohort | To evaluate the association of serum TC and TG with clinical outcomes in chronic peritoneal dialysis (PD) patients. | Patients on chronic peritoneal dialysis; only in end-stage renal disease (ESRD) or patients those very ill patients who died rapidly due to unrelated conditions. | 57.2 +/ 15.3 | 1,053 | 23 +/- 14 months | N/A |
Haim, 1999[29] | Prospective cohort | To investigate the association between elevated blood triglyceride levels and subsequent mortality risk in patients with established coronary heart disease (CHD) | patients with a diagnosis of CHD | 59.76 +/- 6.96 | 11,546 | 61.2 months | N/A |
Hoogeveen, 2001[30] | Case controlled study | To determine the effect of immigration to the USA ion plasma levels of lipoprotein a and other independent risk factors for CHD in Asian Indians | Asian Indians and Asian Indians living in the USA with and without CHD | 44.2 +/- 12.79 | 309 | NR | Coronary heart disease - incidents not specifically defined |
Jonsdottir, 2002[31] | Prospective cohort | To examine the relationship between the relative risk of baseline variables and verified MI or coronary death in individuals with no prior history of MI | male and female from Reykjavik and adjusted communities | 52.7 +/- 8.71 | 18,569 | Mean 208.8 months | N/A |
Lamarche, 1995[32] | Prospective cohort | To confirm the importance of both elevated plasma cholesterol and decreased high density lipoprotein cholesterol levels as risk factors for ischemic heart disease | men without ischemic heart disease | 57.5 | 2,103 | 60 months | Effort angina pectoris, coronary insufficiency, nonfatal MI, and coronary death |
Lloret Linares, 2008[33] | Retrospective cohort | to assess retrospectively the prevalence and the predictive factors of acute pancreatitis (AP) | Patients referred by their general practitioner or general hospital for very high TG levels. | 47 +/- 10.7 | 129 | NR | N/A |
Lu, 2003[34] | Prospective cohort | To determine whether non- HDL cholesterol, a measure of total cholesterol minus HDL cholesterol, is a predictor of CVD in patients with DM | American Indians with DM | 57.28 +/- 8 | 2,108 | 108 months | Coronary heart disease, MI, stroke, and other CVD |
Malone, 2009[35] | Prospective cohort | This study evaluated cardiometabolic risk factors and their relationship to prevalent diagnosis of acute MI (AMI) and stroke. | People continuously receiving health insurance benefits during study | 56.8 +/- 0.03 | 170,648 | 24 months | N/A |
Mazza, 2005[36] | Prospective cohort | To evaluate whether TG level is a risk factor for CHD in elderly people from general population, and to look for interactions between TG and other risk factors. | elderly people from general population CHD in elderly people from general population | 73.8 +/- 5 | 3,257 | 144 months | N/A |
Mora, 2008[37] | Prospective cohort | To evaluate levels of lipids and apolipoproteins after a typical meal and to determine whether fasting compared with non-fasting alters the association of these lipids and apolipoproteins with incident CVD. | Healthy women, aged > = 45 years, who were free of self- reported CVD or cancer at study entry and with follow-up for incident CVD. | 54.7 | 26,330 | 136.8 months | Nonfatal MI, percutaneous coronary intervention, coronary artery bypass grafting, nonfatal stroke, or cardiovascular death |
Noda, 2010[38] | Case controlled study | To examine the prediction of coronary risk factors and evaluation of the predictive value for MI among Japanese middle-aged male workers. | Japanese male workers | cases 50.4 + -5.3, controls 50.4 + -5.5 years | cases 204 and controls 408 | 36 months | N/A |
Rubins, 1999[39] | RCT | To analyze the role of raising HDL cholesterol level and lowering triglyceride levels to reduce the rate of coronary events in patients with existing cardiovascular disease | men with coronary heart disease with absence of serious coexisting conditions | 64 + -7 | 1267 (placebo) | 61.2 months | combined incidence of nonfatal MI or death from coronary heart disease |
Samuelsson, 1994[40] | Prospective cohort | To analyze the importance of DM and HTG as potential risk factors for CHD in middle-aged, treated hypertensive men | middle aged treated hypertensive men | 52 +/- 2.3 | 686 | 180 months | Non-fatal MI, a fatal MI, a death certificate statement of coronary atherosclerosis as the cause of death |
Schupf, 2005[41] | Prospective cohort | To investigate the relationship between plasma lipids and risk of death from all causes in non demented elderly | Community- based sample of Medicare recipients without dementia | 76.1 | 2,277 | Mean 36 +/- 30 months | N/A |
Sprecher, 2000[42] | Prospective cohort | To evaluate the predictive value of serum triglyceride levels on mortality in post coronary artery bypass graft(CABG) diabetic patients with subsequent analysis by sex | Diabetic post CABG patients at a large metropolitan hospital | 63 +/- 9 | 1,172 | 84 months | N/A |
Tanko, 2005[43] | Prospective cohort | To investigate the relative utility of enlarged waist combined with elevated TG (EWET) compared with the National Cholesterol Education Program (MS-NCEP) criteria in estimating future risk of all-cause and cardiovascular mortality | Postmenopausal women | 60.4 +/- 7.1 | 557 | 8.5 +/- 0.3 years | N/A |
Tsai, 2008[44] | Retrospective cohort | To assess the effect of a single and a combination of "pre-disease" risk factors of metabolic syndrome on the overall and cardiac mortality. | civil servants and teachers 40 years and older | 52.4 + - 8.0 | 35,259 | median follow-up of 15 years | N/A |
Upmeier, 2009[45] | Prospective cohort | To determine whether high levels of serum total cholesterol and low levels of HDL are related to increased mortality in elderly | Home dwelling older adults residents in Finland | 70 years | 877 | 144 months | N/A |
Valdivielso, 2009[46] | Prospective cohort | To study the prevalence, risk factors and vascular disease associated with moderate and sever HTG in an active working population | Active working population of Spain | 36 ± 10 years | 594,701 | NR | documented prior medical diagnosis of heart disease, cerebrovascular disease or peripheral arterial disease |
Wier, 2003[47] | Prospective cohort | To investigate the relationship between triglyceride and stroke outcome | nondiabetic patients presenting to acute stroke unit | Median 70 years | 1310 | mean 1195 days | N/A |
Study Label | Cohort Selection (sampling) | Outcome ascertainment* | Adjustments for variables | % lost to follow-up | Definition of hypertriglyceridemia |
---|---|---|---|---|---|
Acarturk, 2004[13] | not random; all patients admitted for diagnostic coronary angiography | chart review, angiography results | NR | NR | TG value in the blood was used as a continuous number (variable). OR expresses increased risk per unit of serum TG level |
Bansal, 2007[14] | derived from women health study, previously completed randomized controlled trial of aspirin and vitamin E | chart review, events adjudicated by an end point committee | adjusted for treatment assignment to ASA, vitamin E, beta carotene, age, BP, smoking status, and use of hormone therapy, levels of total cholesterol and HDL-C, history of DM, BMI, high-sensitivity C- reactive protein | 0 | TG value in the blood was used as a continuous number (variable). OR expresses increased risk per unit of serum TG level |
Barrett-Connor, 1987[15] | random sample | chart review, ICD or billing codes, death certificates | adjust by TG level, age, BP, BMI, smoking habit, DM, family history of heart attack | 0.5% | Compared normal to "borderline HTG", defined as TG between 240-500 mg/dL (2.7-5.65 mmol/L) |
Bass, 1993[16] | subset of female participants in the Lipid Research Clinics' Follow-up Study | chart review, annual checkups | Adjusted for age, HTN, DM, smoking, history of heart disease and estrogen use | NR | Compared TG < 200 mg/dL (< 2.25 mmol/L) to elevated 200 to 399 mg/dL (2.25 to 4.49 mmol/L) and high > 400 mg/dL (> 4.50 mmol/L) |
Bonaventure, 2010[17] | not random and not consecutive: recruited from electoral rolls | Death certificates and autopsy reports, ascertained the same way in cases and controls | medical history of MI, stroke, or peripheral arterial disease, as well as smoking and alcohol consumption status (never, former, current), excess weight, elevated BP, DM, apolipoprotein E (APOE) genotype, low-dose aspirin intake, and lipid-lowering treatment | NR | They compared tertiles or quintiles: TG < 83.4 mg/dL (< 0.94), 84.2-117.8 mg/L (0.95-1.33), and > 118.7 mg/dL (1.34 mmol/L) |
Carlson, 1988[18] | consecutive sample (all patients presenting with HTG) | chart review, ascertained the same way in cases and controls, done without knowledge of patients' TG level | NR | 13.4% | 3 groups according to TG levels. Low = TG < 132.9 mg/dL (1.5 mmol/L), intermediate = TG 132.9-177.2 mg/dL (1.5-2.0 mmol/L), high = TG > 177.2 (2.0 mmol/L). |
Chan, 2005[19] | not random; consecutive patients with type 2 DM, not HPTG | chart review, death registry | Adjusted for sex and age. stepwise linear regression with BMI, WC, HbA1c, FPG and HOMA as independent variables and lipid profile as dependent variable | 0 | Unclear |
Chester, 1995[20] | consecutive sample (all men presenting with HTG and are awaiting routine angioplasty) | chart review, done without knowledge of patients' TG level | The potential predictor variables-that is, risk factors assessed at baseline angiography, for adverse events were analyzed using the multiple logistic regression models. | 2 | TG value in the blood was used as a continuous number (variable). Here OR expresses increased risk per unit of serum TG level: mmol/L |
Czernichow, 2007[21] | consecutive sample | self report, chart review, ICD or billing codes, ascertained differently: self report in all patients, however if a CVD event was reported -- chart review and ICD billing codes were reviewed for those individuals only | Age | NR | Age-adjusted relative risk correlate to one standard deviation increase in TG levels |
Drexel, 2005[22] | consecutive sample | follow up investigation after 2.3 years, Time and causes of death were obtained from national surveys, hospital records | age, sex, and use of lipid-lowering medication | 0 | Unclear |
Eberly, 2003[23] | not random; likely consecutive sample: 2863 men with both nonfasting and fasting TG levels measured at screens 1 and 2 | self report, chart review, ICD or billing codes, death certificates | age, lipids subfractions, glucose level, BP, cigarettes smoked per day, alcohol use, BMI and race | 0 | TG value in the blood was used as a continuous number (variable). Here OR expresses increased risk per unit of serum TG level: mg/dL |
Egger, 1999[24] | not random; likely consecutive sample: Participants of the Caerphilly Heart Disease Study | self report, chart review, ICD or billing codes | age, all three lipid factors, laboratory error and within person variation, blood glucose and diastolic BP, BMI, smoking and markers for pre-existent disease | 12.5 | TG value in the blood was used as a continuous number (variable). Here OR expresses increased risk per unit of serum TG level: mmol/L |
Ellingsen, 2003[25] | not random; likely consecutive sample: 1232 healthy men with elevated cholesterol or coronary risk score included in the study from a pool of 16202 screened men | chart review, ICD or billing codes, ascertained the same way in cases and controls | adjusted for age, BMI, cigarette smoking, total cholesterol, triacylglycerol, glucose, BP, dietary score, alcohol intake, and activity level | 0 | TG value in the blood was used as a continuous number (variable). Here OR expresses increased risk per unit of serum TG level: high TG > or = 178.1 mg/dL (2.01 mmol/L) |
Gaziano, 1997[26] | not random, likely consecutive sample: Men/women < 76 yrs. age with no prior history of CAD discharged from one of 6 Boston area hospitals with the diagnosis of confirmed MI | chart review, medical exam/lab analysis, ascertained differently: cases were interviewed 8 weeks after MI | Adjusted for age, sex, history of HTN, history of DM, body mass index, type A personality, family history of previous MI, alcohol consumption, physical activity, smoking, caloric intake | 12 | they compared quintiles, highest compared to lowest |
Goldberg, 2009[27] | consecutive sample (all patients presenting with HTG) | chart review, telephone calls, ascertained the same way in cases and controls | A time-to-event regression model was performed to establish the role of baseline lipid subfractions, other metabolic risk factors, lifestyle variables, and demographic characteristics in relation to the development of CAD. | 3.8 | high triglyceride level > = 248.1 mg/dL (2.8 mmol/L) |
Habib, 2006[28] | Data from the United States Renal Data System database collected during the prospective Dialysis Morbidity and Mortality Study Wave 2 study | chart review | age, gender, race, weight, height, primary cause of ESRD, hemoglobin, serum albumin, serum calcium phosphate product, serum bicarbonate, residual kidney creatinine clearance, PD parameters (dialysate effluent volume, dialysis creatinine clearance, D/P creatinine ratio after a 4 h dwell), use of lipid-modifying medications and comorbidity characteristics | 0 | TG value in the blood was used as a continuous number (variable). Here OR expresses increased risk per unit of serum TG level: HR is using a reference of TG levels 200-300 mg/dl (2.2-3.4 mmol/L) |
Haim, 1999[29] | not random; likely consecutive sample | chart review, ICD or billing codes | age, previous MI, DM, NYHA class, HTN, LDL cholesterol, glucose, chronic obstructive pulmonary disease, peripheral vascular disease, stroke, angina pectoris, smoking, and lipids | 0.37 | TG value in the blood was used as a continuous number (variable). Here OR expresses increased risk per unit of serum TG level: mg/dL |
Hoogeveen, 2001[30] | Random sample | chart review, clinical exam and investigations, ascertained the same way in cases and controls | Logistic regression applied but no specific adjustments are mentioned | 12 | TG value in the blood was used as a continuous number (variable). Here OR expresses increased risk per unit of serum TG level: 10 mg/dL (0.11 mmol/L) |
Jonsdottir, 2002[31] | not random; likely consecutive: subjects of the Reykjavik Study | self report, chart review, ICD or billing codes | age, high-density lipoprotein cholesterol, total/low-density lipoprotein cholesterol, smoking, body mass index and BP | 0.6 | TG value in the blood was used as a continuous number (variable). Here OR expresses increased risk per unit of serum TG level: mmol/L |
Lamarche, 1995[32] | random sample | chart review, Examination/EKG/death certificate | Adjusted for age, systolic BP, DM, alcohol consumption, and tobacco use | 27 | TG value in the blood was used as a continuous number (variable). Here OR expresses increased risk per unit of serum TG level: TG > 203.8 mg/dL (2.3 mmol/L) |
Lloret Linares, 2008[33] | not random and not consecutive: Patients referred by their general practitioner or general hospital for very high TG levels to Endocrinology Dept. between 2000 and 2005 | self report, chart review | Adjusted for age at hospitalization | NR | TG: lowest 95.1-180 mg/dL (1.1-2.0 mmol/L) vs. highest 360-1505 gm/dL (4.1-17 mmol/L). |
Lu, 2003[34] | not random; likely consecutive: cohort chosen from the strong heart study to include only DM, no baseline CVD | through death certificates and tribal and Indian Health Service hospital records and by direct contact of study personnel with the study participants and their families | Adjusted for age, BMI, smoking status, study center, systolic BP, HbA1c, fibrinogen, insulin, and ratio of albumin to creatinine | 0 | They compared tertiles or quintiles: TG: lower < 111; 111- 175; higher > 175 mg/dL (lower < 1.2; 1.2-2.0; higher > 2.0 mmol/L) |
Malone, 2009[35] | Not random; likely consecutive: Retrospective data from 3 integrated health-care systems that systematically collect and store detailed patient-level data. | Chart review, ICD or billing codes | Adjusted for age, sex, smoking status and site | N/A | lower/normal TG - 80.0 mg/dl (0.9 mmol/L); higher TG - TG = 217.4 mg/dl (2.4 mmol/L) |
Mazza, 2005[36] | random sample | chart review, ICD or billing codes, through the Register Office, general practitioners | Gender, age, DM, obesity, lipids subfractions, serum uric acid, BP, smoking, alcohol and proteinuria | 0 | They compared tertiles or quintiles: TG: First (low) < 97.5 mg/dL (1.01 mmol/L); Fifth (high) > = 156.8 mg/dL (1.77 mmol/L) |
Mora, 2008[37] | Random sample enrolled in the Women's Health Study | Follow-up questionnaires every 6- 12 months | Adjusted for age, randomized treatment assignment, smoking status, menopausal status, postmenopausal hormone use, BP, DM, and BMI | NR | They compared tertiles or quintiles: TG: First (low) < 89.5 mg/dL (1.01 mmol/L); Fifth (high) > = 180.7 mg/dL (2.04 mmol/L) |
Noda, 2010[38] | not random and not consecutive: death related to a MI defined a case, then 2 controls were selected randomly matched by age | Death registration from 1997-2000, done without knowledge of patients' TG level, ascertained the same way in cases and controls | Adjusted for age and 6 risk factors for MI | NR | TG value in the blood was used as a continuous number (variable). Here OR expresses increased risk per unit of serum TG level: High TG > = 150 mg/dL (1.7 mmoml/L) |
Rubins, 1999[39] | not random and not consecutive: to obtain population with appropriate lipid levels, a multi stage screening method that included two lipid profiles obtained one week apart | chart review, clinical and radiologic data, ascertained the same way in cases and controls | Adjustment for baseline variables in the Cox models had a trivial effect on the estimates of the hazard ratios | 2.3% | Two groups: TG < 150 mg/dl (1.7 mmol/L) and TG > 150 mg/dl (1.7 mmol/L) |
Samuelsson, 1994[40] | random sample | chart review | traditional risk factors, end-organ damage status | NR | TG value in the blood was used as a continuous number (variable). Here OR expresses increased risk per unit of serum TG level: RR reported for every 88.6 mg/dL (1 mmol/L) increase in TG level |
Schupf, 2005[41] | random sample | self report, chart review, interviewing relatives | Adjusted for age, sex, ethnicity, and level of education, for BMI or APOE; a history of HTN, DM, heart disease, stroke, or cancer; or current smoking | 0 | They compared tertiles or quintiles: Lowest - < = 98.9 mg/dl (1.1 mmol/L), highest - > 191.2 mg/dl (2.1 mmol/L); RR compared the lowest quartile to the highest quartile. |
Sprecher, 2000[42] | not random; likely consecutive: diabetic patients undergoing primary isolated CABG between 1982 and 1992 at Cleveland Clinic | chart review, clinical exam, labs and CVIR (Cardiovascular Information Registry) | age, sex, left ventricular function, coronary anatomy, history of HTN, BMI, and total cholesterol | NR | highest quartile compared to lower three quartiles (normal) |
Tanko, 2005[43] | not random and not consecutive: recruited via a questionnaire surveys | self report, chart review: Central Registry of the Danish Ministry of Health | Adjusted for age, smoking, and LDL-C), waist circumference | NR | TG value in the blood was used as a continuous number (variable). Here OR expresses increased risk per unit of serum TG level: presented as 2 cutoffs - > 128.5 mg/dL (1.45 mmol/L) - > 149.7 mg/dL (1.69 mmol/L) |
Tsai, 2008[44] | not random; likely consecutive: civil servants and teachers who took the annual physical examination at the Taipei Outpatient Center | chart review, annual exam, national death files | Adjusted for age, gender, fasting glucose, BP, BMI, smoking | NR | They compared tertiles or quintiles: TG normal < 150 mg/dL (1.7 mmol/L, abnormal 150 mg/dL (1.7 mmol/L)-199 mg/dL (2.2 mmol/L), and high abnormal > 200 mg/dL (2.25 mmol/L) |
Upmeier, 2009[45] | not random and not consecutive: mailed invitation to participate to all residents of Turku born in 1920 | Self report, chart review, ICD or billing codes | Adjusted for gender, body mass index, smoking and any history of angina pectoris, stroke, DM, and HTN | NR | They compared TG level quartiles, highest to lowest |
Valdivielso, 2009[46] | not random; likely consecutive | Chart review and self report | age, sex, smoking, HTN, DM, and lipids fractions | NR | Categorized as normal when TG was < 150 mg/dL (< 1.69 mmol/L); the remainder were considered to be HTG |
Wier, 2003[47] | not random; likely consecutive | chart review, done without knowledge of patients' TG level | age, time of resolution of symptoms, smoking, BP, presence of atrial fibrillation and hyperglycemia | 0 | They compared tertiles or quintiles: TG, mmol/l: < = 0.9; 1.0-1.3; 1.4-1.8; > = 1.9. Mg/dL: < = 79.7; 88.6-115.2; 124.0-159.5; > = 168.3 |
Meta-analysis
Subgroup | No. studies | OR | LL | UL | P-effect Size | P- interaction |
---|---|---|---|---|---|---|
Mortality
| ||||||
Men | 3 | 1.03 | 0.95 | 1.12 | 0.49 | 0.04 |
Women | 3 | 1.55 | 1.05 | 2.27 | 0.03 | |
adequate adjustment | 9 | 1.09 | 0.83 | 1.43 | 0.55 | 0.54 |
inadequate adjustment | 3 | 1.22 | 0.94 | 1.59 | 0.14 | |
General population | 10 | 1.09 | 0.87 | 1.37 | 0.46 | 0.49 |
Diabetes | 2 | 1.37 | 0.75 | 2.50 | 0.31 | |
Cardiovascular death
| ||||||
Men | 3 | 1.14 | 0.92 | 1.40 | 0.23 | 0.00 |
Women | 2 | 4.73 | 2.15 | 10.37 | 0.00 | |
adequate adjustment | 5 | 1.88 | 1.12 | 3.15 | 0.02 | 0.84 |
inadequate adjustment | 4 | 1.76 | 1.18 | 2.62 | 0.01 | |
General population | 8 | 1.75 | 1.26 | 2.43 | 0.00 | 0.36 |
Diabetes | 1 | 2.97 | 1.00 | 8.80 | 0.05 | |
Cardiovascular events
| ||||||
Men | 6 | 1.29 | 1.13 | 1.47 | 0.00 | 0.67 |
Women | 2 | 1.21 | 0.94 | 1.57 | 0.14 | |
adequate adjustment | 12 | 1.39 | 1.23 | 1.58 | 0.00 | 0.91 |
inadequate adjustment | 4 | 1.37 | 1.01 | 1.84 | 0.04 | |
General population | 15 | 1.37 | 1.22 | 1.54 | 0.00 | 0.81 |
Diabetes | 1 | 1.42 | 1.11 | 1.81 | 0.00 | |
Myocardial infarction
| ||||||
Men | 2 | 1.22 | 1.09 | 1.37 | 0.00 | 0.24 |
Women | 1 | 1.40 | 1.15 | 1.70 | 0.00 | |
adequate adjustment | 3 | 1.72 | 0.98 | 3.01 | 0.06 | 0.29 |
inadequate adjustment | 3 | 1.26 | 1.15 | 1.39 | 0.00 | |
General population | 5 | 1.27 | 1.13 | 1.44 | 0.00 | 0.13 |
Diabetes | 1 | 2.04 | 1.12 | 3.70 | 0.02 |