Association of lipids with incident heart failure among adults with and without diabetes mellitus multiethnic study of atherosclerosis

Imo A. Ebong, David C. Goff, Carlos J. Rodriguez, Haiying Chen, Christopher T. Sibley, Alain G. Bertoni

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)371-378
Number of pages8
JournalCirculation: Heart Failure
Volume6
Issue number3
DOIs
StatePublished - May 2013

Keywords

  • Diabetes mellitus
  • Heart failure
  • Lipids

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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