Hypertriglyceridemia is associated with an increased risk of peripheral arterial revascularization in high‐risk statin‐treated patients: A large administrative retrospective analysis

Background Peripheral artery disease (PAD) is common, and although it is associated with cardiovascular (CV) morbidity, mortality, reduced quality of life, and increased health care burden, PAD data are relatively scarce. Elevated triglycerides (TG) are associated with and are a risk factor for PAD. Hypothesis Large administrative retrospective data may provide further insight into the relationship between hypertriglyceridemia and peripheral arterial revascularization in high‐risk statin‐treated patients. Methods This retrospective administrative claims analysis of the Optum Research Database included statin‐treated patients aged ≥45 years with diabetes and/or atherosclerotic CV disease enrolled in 2010 and followed for ≥6 months. Patients with TG ≥150 mg/dL were propensity score‐matched to a comparator cohort with TG <150 mg/dL and high‐density lipoprotein cholesterol >40 mg/dL (n = 23 181 in each cohort). A sub‐analysis was conducted in patients with TG 200‐499 mg/dL and a matched comparator cohort (n = 10 990). Clustered P ‐values were calculated using a Cox proportional hazard model with cohort as the independent variable (α, 0.05). Results Multivariate analysis showed a 37% higher rate of peripheral arterial revascularization in the elevated‐TG cohort vs the comparator cohort (hazard ratio [HR] 1.370, 95% confidence interval [CI] 1.263‐1.486; P < .001). Results in the high‐TG sub‐cohort were similar, with a 49% higher rate of revascularization vs the comparator cohort (HR 1.489; 95% CI, 1.348‐1.644; P < .001). Conclusions This large administrative retrospective analysis of high‐risk statin‐treated patients showed that elevated TG (≥150 mg/dL) and high TG (200‐499 mg/dL) were significant predictors of peripheral arterial revascularization; this warrants further study.