Predictive Value of the Triglyceride to High-Density Lipoprotein Cholesterol Ratio for All-Cause Mortality and Cardiovascular Death in Diabetic Patients With Coronary Artery Disease Treated With Statins

Abstract

Background and Aims: Studies have highlighted the role of the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio on subsequent cardiovascular events. However, the association of the TG/HDL-C ratio with survival outcomes in diabetic patients with coronary artery disease (CAD) treated with statins remains unknown. This study aimed to assess the predictive value of the TG/HDL-C ratio for all-cause mortality and cardiovascular death in diabetic patients with CAD treated with statins.Methods: The data of patients with type 2 diabetes and angiographically-confirmed CAD who were undergoing statin therapy and visited Tianjin Chest Hospital between January 2016 and September 2016 were retrospectively collected. The patients were categorized based on the baseline TG/HDL-C ratio tertile. Kaplan-Meier analysis and multivariate Cox proportional hazard regression were applied to assess the role of the TG/HDL-C ratio in predicting all-cause mortality and cardiovascular death.Results: A total of 2,080 patients were included. During the 4-year follow-up, 209 patients died, 136 of whom from cardiovascular death. The Kaplan-Meier analyses showed that an increased TG/HDL-C ratio was associated with an increased risk of all-cause mortality (P < 0.001) and cardiovascular death (P < 0.001). The multivariate cox hazard regression analysis revealed a similar effect of the TG/HDL-C ratio on the risk of all-cause mortality (P = 0.046) and cardiovascular death (P = 0.009). The role of the TG/HDL-C ratio in predicting all-cause mortality and cardiovascular death was similar among all subgroups (P > 0.050). For all-cause mortality, the TG/HDL-C ratio significantly improved the C-statistic from 0.799 to 0.812 (P = 0.018), and the net reclassification index (NRI) and integrated discrimination index (IDI) were 0.252 (95% CI: 0.112–0.392; P < 0.001) and 0.012 (95% CI: 0.003–0.022; P = 0.012), respectively. Similarly, for cardiovascular death, the TG/HDL-C ratio significantly improved the C-statistic from 0.771 to 0.804 (P < 0.001), and the NRI and IDI were 0.508 (95% CI: 0.335–0.680; P < 0.001) and 0.033 (95% CI: 0.015–0.050; P < 0.001).Conclusion: TG/HDL-C ratio might be useful for predicting all-cause mortality and cardiovascular death in diabetic patients with CAD treated with statins.

Salivary metabolic signatures of carotid atherosclerosis in patients with type 2 diabetes hospitalized for treatment

“…Results of OPLS analysis with IMT as the outcome revealed clinical and metabolomic markers that exhibited a covariation with atherosclerotic burden in T2D patients. At the time of admission as well as after treatment, the severity of carotid atherosclerosis was associated with clinical markers in relation to an unfavorable lipid profile, such as lower HDL-C and higher TG, which is in agreement with several previous reports showing that increased TG/HDL-C ratio is an independent predictor of carotid atherosclerosis ( Pacifico et al, 2014 ), as well as increased risk of CVD and all-cause mortality in patients with T2D ( Wang et al, 2021b ), and also non-diabetic subjects ( Prasad et al, 2019 ; Sultani et al, 2020 ). The hsCRP is a known risk factor of CVD as well, but our analyses did not find it among its top predictors.…”

Association between the Triglyceride to High-Density Lipoprotein Cholesterol Ratio and Mortality in Maintenance Haemodialysis Patients

“…Compared with traditional lipid pro les, TG/HDL-C has been discovered to be a more accurate risk indicator of all-cause death and CV events [9][10][11]20 , metabolic syndrome 21 , insulin resistance 22 and incidence of diabetes 23,24 in the general population. The ratio is also used in the prediction of mortality in diabetic patients 25 . However, because of the unique characteristics and distinct lipid pro les of HD patients and the fact that the correlation of serum lipid levels with prognosis is different in these patients compared to others, it is not appropriate to extrapolate these ndings from the general population to HD patients.…”

Blocking MG53 S255 Phosphorylation Protects Diabetic Heart From Ischemic Injury

“…To date, >60% deaths of T2D patients are caused by cardiovascular complications, and patients with diabetes experience poorer prognosis than those with cardiovascular diseases in the absence of diabetes. 2,3,[25][26][27][28] Since systemic delivery of rhMG53-WT, but not rhMG53-S255A, exacerbated hyperglycemia and insulin resistance in diabetic animals (Figure 5C-5F), we speculated that rhMG53-S255A is superior to rhMG53-WT in treating cardiac conditions with comorbidity of diabetes. Indeed, in 8-week-old male diabetic db/db mice challenged with I/R (Figure S10A), the protective effect of rhMG53-S255A was significantly stronger than that of rhMG53-WT, as manifested by greater reductions in the infarct size (Figure 6A), although both rhMG53-WT and rhMG53-S255A were able to ameliorate cardiac I/R damage (Figure 6A-6C).…”

“… 1 In fact, over 60% of T2D patients die of cardiovascular complications. 2 , 3 In 2019, American Heart Association published a statement to highlight the internal connection of diabetes with cardiovascular comorbidities and the importance of developing therapeutic strategies to treat both conditions cohesively. 4 Unfortunately, therapeutic options for treating these comorbidities are limited, because diabetes compromises the cellular protective signaling and increases the myocardial vulnerability toward acute myocardial damage, such as myocardial infarction and ischemia/reperfusion (I/R) injury, 5 which makes the management of T2D patients experiencing myocardial infarction a big challenge in clinical practice.…”