TG risk stratification
Risk varies by TG stratum1
- CV risk is highest at TGs 500-880 mg/dL
- AP risk increases at ≥500 mg/dL; particularly high at ≥1000 mg/dL
sHTG in the 2026 ACC/AHA/ADA dyslipidemia and cardiovascular-kidney-metabolic (CKM) syndrome guidelines
<500 mg/dL
The 2026 ACC/AHA/ADA guidelines on dyslipidemia and CKM syndrome, along with the National Lipid Association and Endocrine Society guidelines, identify TGs <500 mg/dL as a critical threshold for reducing acute pancreatitis risk.1-4
Confirming sHTG
Workup before treatment1
- Confirm fasting TGs ≥500 mg/dL on repeat measurement. Identify secondary causes (uncontrolled diabetes, alcohol, obesity, etc)
ASCVD risk assessment
Beyond LDL-C: apoB and non–HDL-C1
- Non–HDL-C and apoB are considered more accurate estimators of ASCVD risk than LDL-C in patients with hypertriglyceridemia
Response monitoring
When to reassess TG levels1
- Perform a lipid profile 1-3 months after treatment initiation or dose adjustment, then every 6-12 months thereafter
ACC=American College of Cardiology; ADA=American Diabetes Association; AHA=American Heart Association; AP=acute pancreatitis; apoB=apolipoprotein B; ASCVD=atherosclerotic cardiovascular disease; CV=cardiovascular; LDL-C=low-density lipoprotein cholesterol; non–HDL-C=non–high-density lipoprotein cholesterol; sHTG=severe hypertriglyceridemia; TG=triglyceride.