Ability of non-fasting and fasting triglycerides to predict coronary artery disease in lupus patients

Abstract

Objectives: To test whether non-fasting and fasting triglyceride (TG) levels differ in individual patients and whether TG (non-fasting and fasting) levels predict coronary artery disease (CAD) in lupus patients. Methods: Using predefined criteria for a patient's inclusion in this study, we identified the first available set of non-fasting and fasting TG measurements on each individual lupus patient seen in the clinic since 1996. We dichotomized TG values as normal/abnormal and determined whether non-fasting and fasting TG levels differ in each individual patient. We determined whether TG levels (non-fasting and fasting) predict CAD in all consecutive lupus patients seen in the clinic since 1973 using time-dependent time-to-event analysis and stepwise reduction analysis. Results: Part 1: 514 patients were identified. The time between first non-fasting and fasting TG measurements available was 3.2 months. Examining dichotomized TG values as normal/abnormal, there was concordance between fasting and non-fasting TG in 92% of the visits. Non-fasting TG levels were 0.16 (0.75) higher than fasting TG levels (P < 0.001). Part 2: among 1289 patients, 638 had at least one elevated TG level and the length of follow-up from the first TG level recorded to CAD or last clinic visit was 8.82 years. One hundred and four patients developed CAD. TG (non-fasting and fasting) levels predicted CAD with a hazard ratio of 1.15 (95% CI 1.02, 1.29). Conclusions: Although non-fasting TG levels were statistically higher than the fasting TG levels, the clinical significance of this difference is uncertain. TG (non-fasting and fasting) levels can predict CAD in lupus patients. © The Author 2011. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.