Association of Elevated Triglycerides With Increased Cardiovascular Risk and Direct Costs in Statin-Treated Patients  Peter P. Toth, MD, PhD, Sephy Philip, RPh, PharmD, Michael Hull, MS, Craig Granowitz, MD, PhD  Mayo Clinic Proceedings  Volume 94, Issue 9, Pages 1670-1680 (September 2019) DOI: 10.1016/j.mayocp.2019.03.028 Copyright © 2019 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 1 Patient disposition. HDL-C = high-density lipoprotein cholesterol; TG = triglycerides. aPopulation used for patient characteristics and other analyses. Mayo Clinic Proceedings 2019 94, 1670-1680DOI: (10.1016/j.mayocp.2019.03.028) Copyright © 2019 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 2 Effects of elevated triglyceride (TG) cohort variable in multivariate analyses of composite and individual major cardiovascular (CV) events, total direct health care costs, and initial inpatient hospital stay.a,b aElevated TG prematch cohort: TG ≥150 mg/dL (N=25,452 patients); comparator prematch cohort: TG <150 mg/dL and high-density lipoprotein cholesterol >40 mg/dL (N=31,805 patients). bSeparate prematch multivariate analyses of major CV events, total health care costs, and initial inpatient stay were performed. Covariates included TG cohort, as represented here, along with age (45-54, 55-64, ≥65 years), sex, insurance coverage type, geographic region of enrollment, baseline clinical characteristics (diabetes, atherosclerotic CV disease, low-density lipoprotein cholesterol laboratory result in relation to median), and baseline medication use (fibrate, prescription omega-3, both, and neither). cMultivariate analysis using Cox proportional hazards model. dEvent occurred in an inpatient setting with discharge status indicating a nonfatal event (absence of a CV-related death; CV-related death was defined as a death in the follow-up period [as identified with discharge status or the US Social Security Administration’s Death Master File]) based on diagnosis code for major CV events (myocardial infarction [MI], stroke, revascularization) in the first or second position that occurred in an emergency department setting within 1 day of a death date or in an inpatient stay with a discharge date within 7 days of a death date. eGeneralized linear model (gamma distribution, log link). Mayo Clinic Proceedings 2019 94, 1670-1680DOI: (10.1016/j.mayocp.2019.03.028) Copyright © 2019 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 3 Effects of elevated triglycerides (TG) cohort variable in multivariate analyses of composite and individual major cardiovascular (CV) events with addition of non–high-density lipoprotein cholesterol (non–HDL-C) to the model.a,b aElevated TG prematch cohort: TG ≥150 mg/dL (N=25,452 patients); comparator prematch cohort: TG <150 mg/dL and HDL-C >40 mg/dL (N=31,805 patients). Non–HDL-C was calculated for patients with both a total cholesterol and HDL-C laboratory result present at baseline. bCox proportional hazards model. cEvent occurred in an inpatient setting with discharge status indicating a nonfatal event (absence of CV-related death; CV-related death was defined as a death in follow-up period [as identified with discharge status or the US Social Security Administration’s Death Master File]) based on diagnosis code for major CV event (myocardial infarction [MI], stroke, revascularization) in the first or second position that occurred in emergency department setting within 1 day of a death date or in an inpatient stay with a discharge date within 7 days of a death date. Mayo Clinic Proceedings 2019 94, 1670-1680DOI: (10.1016/j.mayocp.2019.03.028) Copyright © 2019 Mayo Foundation for Medical Education and Research Terms and Conditions