Nonfasting Triglycerides, Low-Density Lipoprotein Cholesterol, and Heart Failure Risk: Two Cohort Studies of 113 554 Individuals

OBJECTIVE: The prevalence of heart failure is increasing in the aging population, and heart failure is a disease with large morbidity and mortality. There is, therefore, a need for identifying modifiable risk factors for prevention. We tested the hypothesis that high concentrations of nonfasting triglycerides and low-density lipoprotein cholesterol are associated with higher risk of heart failure in the general population.

APPROACH AND RESULTS: We included 103 860 individuals from the Copenhagen General Population Study and 9694 from the Copenhagen City Heart Study in 2 prospective observational association studies. Nonfasting triglycerides and low-density lipoprotein cholesterol were measured at baseline. Individuals were followed for ≤23 years, during which time 3593 were diagnosed with heart failure. Hazard ratios were estimated using Cox proportional hazard regression models. In the Copenhagen General Population Study, stepwise higher concentrations of nonfasting triglycerides were associated with stepwise higher risk of heart failure (P for trend <0.001), with a multivariable adjusted hazard ratio of 2.59 (95% confidence interval, 1.48-4.54) for individuals with nonfasting triglycerides ≥5 mmol/L (440 mg/dL) compared with individuals with concentrations <1 mmol/L (88 mg/dL). Concentrations of low-density lipoprotein cholesterol were not associated with risk of heart failure. Results were independently confirmed in the Copenhagen City Heart Study.

CONCLUSIONS: Stepwise higher concentrations of nonfasting triglycerides were associated with stepwise higher risk of heart failure; however, concentrations of low-density lipoprotein cholesterol were not associated with risk of heart failure in the general population.