Association between postprandial triglycerides and coronary artery disease detected by coronary computed tomography angiography

- Postprandial triglyceride decay is reduced in subjects with coronary disease detected by computed tomography angiography.
- Differences between those presenting or not obstructions were found on the late phase of triglyceride decay.
- Delayed triglyceride clearance was partially explained by lower fasting HDL-cholesterol.

BackgroundStudies have demonstrated the association of severe anatomical coronary artery disease (CAD) with postprandial triglycerides (TG) concentrations. Nevertheless the relationship between less severe atherosclerosis plaque burden and postprandial TG is less established.Objectiveto study the relationship between postprandial TG and CAD detected by coronary computed tomographic angiography (CTA).Material and methods130 patients who underwent an oral fat tolerance test were enrolled (85 with CAD detected by CTA and 45 without). Postprandial lipemia was studied by measuring TG from T0h to T6h with 2-h intervals, and analyzed the TG change over time using a longitudinal multivariable linear mixed effects model with the log normal of the TG as the primary outcome.ResultsThe majority of individuals with CAD had non-obstructive disease (63.3%) Patients with CAD had a slower clearance of postprandial TG change from 4 h to 6 h (p < 0.05) compared to patients without CAD. These results remained significant after adjustment for fasting TG and glucose, age, gender, body mass index, and waist circumference. However, those differences did not reach statistical significance after adjustment for fasting HDL-C.ConclusionPatients with mild (<25% lumen obstruction) and moderate CAD (25-50% lumen obstruction) detected by coronary CTA had an impaired postprandial metabolism, with a delayed TG clearance, when compared to individuals with no CAD. This difference was partially explained by the lower HDL-C. Thus, though postprandial TG may contribute to the development of CAD, this association is partially related to low HDL-C.