Triglycerides and Residual Risk of CVD

Low-density lipoprotein cholesterol (LDL-C) is a primary target for lipid-lowering therapy in the guidelines for the management of dyslipidemia and prevention of atherosclerotic cardiovascular disease (ASCVD) 1,2) .However, it is well-documented that even when LDL-C levels are kept very low, a risk of CVD event persist, the phenomena known as "a residual risk" 3) .Metabolic factors, such as high levels of triglyceride-rich lipoproteins (TRLs) and their remnants, observed in individuals with high triglyceride (TG) levels, are potential targets to address the residual risk for prevention of ASCVD.Several prospective cohort studies have reported that high TG levels are associated with the risk of firstever ASCVD in the Japanese general populations [4][5][6] . Oe of those studies showed that the hazard ratio per 1-standard deviation higher TG level for ischemic CVD was greater in individuals with LDL-C 140 mg/dL than in those with LDL-C 140 mg/dL 6) .These results indicate that hypertriglyceridemia is a predictor of ischemic CVD; however, the strength of the association between hypertriglyceridemia and ischemic CVD might differ among individuals with differing CVD risk factor profiles and estimated CVD risks.Mizuta et al. investigated the association between TG levels and the risk for the incidence of major adverse cardiovascular events (MACE) and the interaction by prevention categories (primary or secondary) in the association, based on retrospective cohort studies using a nationwide database among Japanese workers 7) .Using a very large number of participants, their investigation was unique in its comparison of the predictive ability of the TG level for incident MACE between primary and secondary prevention populations.The results indicated a "the