Triglyceride levels predict stroke and TIA risk in CHD patients


NEW YORK (Reuters Health) – Among patients with documented coronary heart disease (CAD), high triglyceride levels are an independent risk factor for stroke and transient ischemic attack (TIA), and this relationship is independent of age, sex, patient characteristic, and cholesterol fraction, Israeli researchers report in the December 11th issue of Circulation: Journal of the American Heart Association.

"Our main finding in this study is that elevated blood triglycerides increase a person's risk of suffering an ischemic stroke," lead author, Dr. David Tanne from the Chaim Sheba Medical Center, Tel-Hashomer, said in a journal statement.

"Those with high blood triglycerides (over 200 mg/dL) have a nearly 30% higher risk of suffering a stroke, after taking into account other risk factors for stroke such as high blood pressure, cigarette smoking or diabetes," he added.

Dr. Tanne and colleagues collected data for 11,177 CHD patients, 40 to 74 years of age, with no history of stroke or TIA. During 6-to-8 years of follow-up, 941 patients had nonhemorrhagic cerebrovascular disease. Of these patients, 487 had ischemic stroke or TIA.

Mean triglyceride levels among the patients who had a stroke or TIA were higher and mean levels of HDL cholesterol were lower, as were percentages of cholesterol contained in the HDL cholesterol moiety, compared with patients who did not have a stroke or TIA (p < 0.01), the researchers found.

When triglyceride levels were greater than 200 mg/dL, the adjusted odds ratio for ischemic stroke or TIA was 1.27. The odds ratio for a 5% decrease in the percent of HDL cholesterol was 0.87, Dr. Tanne's team notes. However, a high percent of HDL cholesterol proved to be an independent protective factor against stroke or TIA in patients with CHD, they add.

Dr. Tanne and colleagues conclude that "this study shows for the first time that high triglycerides, in addition to fractionated cholesterol, are associated with increased risk of ischemic stroke/TIA in a large cohort of men and women with CHD."

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