Triglyceride Variability and Risk of Adverse Cardiovascular Outcomes-Results from the ACCORD Trial

The potential role of visit-to-visit variability of lipid parameters in risk of adverse cardiovascular events is not well established. We used data from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial to examine the relationship between visit-to-visit variability in triglycerides and risk of both heart failure (HF) events and the primary CVD outcome. Variability of triglycerides was computed as coefficient of variation (CV-Trig). In both age-adjusted models and models adjusting for covariates that differed between those who did and did not develop HF, CV-Trig was associated with risk of HF (Model 2, HR = 1.13, p = 0.03) (Table). This association was somewhat attenuated when accounting for mean triglyceride level (Table). Conversely, we did not observe any relationship between CV-Trig and the primary CVD outcome in ACCORD (Model 1: HR = 1.04, p = 0.21) (Table). LDL variability was not linked to risk of HF in ACCORD. Our results suggest that variability in triglycerides may play a more important role in HF than in other cardiovascular outcomes. Studies to elucidate mechanisms which may underlie these risk patterns are warranted. Disclosure D.S.Nuyujukian: None. J.Zhou: None. J.Koska: None. P.Reaven: Research Support; Dexcom, Inc. Funding National Heart, Lung, and Blood Institute (F32HL156626, R21HL150374, R21HL150268, R01HL138969)