Background
Elevated triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio has
been utilised as a predictor of outcomes in patients with adverse cardiometabolic
risk profiles. In this study, we examined the prognostic value of elevated TG/HDL-C
level in an Australian population of patients with high clinical suspicion of coronary
artery disease (CAD) presenting for coronary angiography.
Methods
Follow-up data was collected for 482 patients who underwent coronary angiography in
a prospective cohort study. The primary endpoint was all-cause mortality and the secondary
endpoint was a major adverse cardiac event (MACE). Patients were stratified into two
groups according to their baseline TG/HDL-C ratio, using a TG/HDL-C ratio cut point
of 2.5.
Results
The mean follow-up period was 5.1 ± 1.2 years, with 49 all-cause deaths. Coronary
artery disease on coronary angiography was more prevalent in patients with TG/HDL-C
ratio ≥2.5 (83.6% vs. 69.4%, p = 0.03). On the Kaplan-Meier analysis, patients with
TG/HDL-C ratio ≥2.5 had worse long-term prognosis (p = 0.04). On multivariate Cox
regression adjusting for established cardiovascular risk factors and CAD on coronary
angiography, TG/HDL-C ratio ≥2.5 was an independent predictor of long-term all-cause
mortality (hazard ratio [HR] 2.10, 95% confidence interval [CI] 1.04–4.20, p = 0.04).
On multivariate logistic regression adjusting for known cardiovascular risk factors
and CAD on coronary angiography, TG/HDL-C ratio ≥2.5 was strongly associated with
an increased risk of long-term MACE (odds ratio [OR] 2.72, 95% CI 1.42–5.20, p = 0.002).
Conclusions
Elevated TG/HDL-C ratio is an independent predictor of long-term all-cause mortality
and is strongly associated with an increased risk of MACE.
Keywords
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Article info
Publication history
Published online: April 09, 2019
Accepted:
March 31,
2019
Received in revised form:
March 25,
2019
Received:
April 17,
2018
Identification
Copyright
© 2019 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
