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Elevated Triglycerides to High-Density Lipoprotein Cholesterol (TG/HDL-C) Ratio Predicts Long-Term Mortality in High-Risk Patients - 28/02/20

Doi : 10.1016/j.hlc.2019.03.019 
Rohullah Sultani, BMedSci, MD a, e, , David C. Tong, MBBS a, b, Matthew Peverelle, MD a, e, Yun Suk Lee, MD a, e, Arul Baradi, MBBS c, d, Andrew M. Wilson, MBBS, PhD a, d
a Department of Cardiology, St. Vincent’s Hospital, Melbourne, Vic, Australia 
b Department of Cardiology, Peninsula Health, Melbourne, Vic, Australia 
c Department of Cardiology, Werribee Mercy Hospital, Melbourne, Vic, Australia 
d Department of Cardiology, St. Vincent’s Private Hospital, Melbourne, Vic, Australia 
e University of Melbourne, Department of Medicine, St. Vincent’s Hospital, Melbourne, Vic, Australia 

Corresponding author at: Goulburn Valley Health, Graham Street, Shepparton, 3630, Victoria, Australia. Fax: +61 3 8845 7073.Goulburn Valley HealthGraham StreetSheppartonVictoria3630Australia

Resumen

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.

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Keywords : Triglycerides to high-density lipoprotein cholesterol ratio, Coronary artery disease, All-cause mortality, Major adverse cardiovascular events, Coronary, Angiography


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© 2019  Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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