Recent publications on Residual Risk

Findings from the standard versus intEnsive statin therapy for hypercholesteroleMic Patients with diAbetic retinopaTHY (EMPATHY) study implicate serum triglycerides as a predictor of future cardiovascular events in statin-treated individuals with diabetes mellitus and retinopathy. EMPATHY is a multicentre, prospective, randomized, open-label, blinded-endpoint study evaluating standard versus intensive statin therapy in subjects with diabetes mellitus. The current analysis included data from 5,042 subjects who were followed for a median of 3 years. The key outcomes of interest were 1) major adverse cardiac events, a composite of myocardial infarction, stroke, or cardiac death; and 2) cardiovascular disease, a composite of myocardial infarction, unstable angina, ischemic stroke, large artery disease or peripheral arterial disease. Using Cox-regression hazard modelling, each 10 mg/dL increase in serum triglycerides was associated with a 2.1% relative increase in major cardiac events (adjusted hazard ratio 1.021, 95% confidence interval [CI] 1.007-1.035, p?=?0.0025) and a 2.3% relative) increase in cardiovascular disease (adjusted hazard ratio 1.023, 95% CI 1.013-1.034, p?=?0.0000077). Compared with the lowest quintile for serum triglycerides (<79 mg/dl), individuals in the top quintile (>185?mg/dl) were at 89% increased risk for major cardiac events (p?=?0.04) and 90% increased risk for cardiovascular disease (p?=?0.007). This increased risk was independent of low-density lipoprotein cholesterol levels and statin treatment. In conclusion, these findings suggest that measurement of serum triglycerides may offer additional information for risk prediction in individuals with diabetes mellitus and retinopathy.