TY - JOUR
T1 - Association of lipids with incident heart failure among adults with and without diabetes mellitus multiethnic study of atherosclerosis
AU - Ebong, Imo A.
AU - Goff, David C.
AU - Rodriguez, Carlos J.
AU - Chen, Haiying
AU - Sibley, Christopher T.
AU - Bertoni, Alain G.
PY - 2013/5
Y1 - 2013/5
N2 - 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 (Pinteraction<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.
AB - 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 (Pinteraction<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.
KW - Diabetes mellitus
KW - Heart failure
KW - Lipids
UR - http://www.scopus.com/inward/record.url?scp=84879210784&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84879210784&partnerID=8YFLogxK
U2 - 10.1161/CIRCHEARTFAILURE.112.000093
DO - 10.1161/CIRCHEARTFAILURE.112.000093
M3 - Article
C2 - 23529112
AN - SCOPUS:84879210784
SN - 1941-3297
VL - 6
SP - 371
EP - 378
JO - Circulation: Heart Failure
JF - Circulation: Heart Failure
IS - 3
ER -