The triglyceride/high-density lipoprotein cholesterol ratio predicts all-cause mortality in women with suspected myocardial ischemia

Abstract

High triglycerides (TG) and low high density lipoprotein cholesterol (HDL-C) are important cardiovascular risk factors in women. The prognostic utility of the TG/HDL-C ratio, a marker for insulin resistance and small dense low density lipoprotein particles, is unknown among high risk women. Methods We studied 544 women without prior myocardial infarction or coronary revascularization, referred for clinically indicated coronary angiography and enrolled in the Women’s Ischemia Syndrome Evaluation (WISE). Fasting lipid profiles and detailed demographic and clinical data were obtained at baseline. Multi-variate Cox-proportional hazards models for all cause mortality and cardiovascular events (death, myocardial infarction, heart failure, stroke) over a median follow-up of 6 years were constructed using log TG/HDL-C ratio as a predictor variable and accounting for traditional cardiovascular risk factors. Results Mean age was 57±11 years, 84% were white, 55% hypertensive, 20% diabetic, 50% current or prior smokers. TG/HDL-C ranged from 0.3 to 18.4 (median 2.2, first quartile 0.35 to <1.4, fourth quartile 3.66–18.4). Deaths (n=33) and CV events (n=83) increased across TG/HDL-C quartiles (both p<0.05 for trend). TG/HDL-C was a strong independent predictor of mortality in models adjusted for age, race, smoking, hypertension, diabetes, and angiographic coronary disease severity (HR 1.95, 95% CI 1.05, 3.64, p=0.04). For cardiovascular events, the multivariate HR was 1.54 (95% CI 1.05, 2.22, p=0.03) when adjusted for demographic and clinical variables, but became non-significant when angiographic results were included. Conclusion Among women with suspected ischemia, the TG/HDL-C ratio is a powerful independent predictor of all cause mortality and cardiovascular events.

Acute ST‐elevation Myocardial Infarction in Young Patients: 15 Years of Experience in a Single Center

“…14 -16 High TG and low HDL-C levels, which characterize the dyslipidemia of metabolic syndrome, have roles in atherosclerosis and coronary heart disease development. [16][17][18] In addition, the current study showed that obesity was a risk factor of STEMI in young patients. All these findings suggest that young patients with STEMI are more likely to meet most of the Adult Treatment Panel III criteria for metabolic syndrome, including obesity, high TG, and low HDL-C levels.…”

Functional Assessments and Histopathology of Hepatorenal Tissues of Wistar Rats Infused with Carbon Tetrachloride and Treated with Raw and Hydrothermal Processed Herbs

“…According to the TAG/HDL-C and LDL-C/HDL-C ratios of the present study, adjustments of SLP patterns in the fibrotic rats, irrespective of the type of herbal treatment they received, indicated incidences of atherogenicity as defined elsewhere. 39,58,61,62,63 The massive disarrangement of hepatic tissues architecture of untreated fibrotic rats (Group 3) correlated with the levels of alterations of serum indicators, namely, serum ALT, AST and ALP activities as well as serum TBC as previously described. 12,13,98,99 Additionally, photomicrograph section of hepatic tissues of fibrotic rats ( Figure 6) revealed and confirmed CCl 4 -induced necrosis and steatosis as previously described.…”

Plasma Levels of High-Density Lipoprotein Cholesterol and Outcomes in Pulmonary Arterial Hypertension

“…HDL-C had a much stronger association with mortality and clinical worsening than either index, and remained significant when adjusted for both HOMA-IR and TG/HDL-C ratio. Many studies have shown that insulin resistance and the metabolic syndrome carry a higher risk of systemic cardiovascular events (30)(31)(32)(33)(34), but this is not universal (35)(36)(37)(38)(39). In one study (32) cardiovascular events were more closely dependent on insulin resistance than HDL-C levels, whereas another study suggested that HDL-C was the better predictor (37).…”