Triglyceride to high-density lipoprotein cholesterol ratio as a predictor of long-term mortality in patients with coronary artery disease after undergoing percutaneous coronary intervention: a retrospective cohort study

Dai, Xin-Ya; Zheng, Ying‐Ying; Tang, Junnan; Yang, Xinwei; Guo, Qianqian; Zhang, Jianchao; Cheng, Meng-Die; Song, Feng-Hua; Liu, Zhiyu; Wang, Kai; Jiang, Ling; Fan, Lei; Yue, Xiao-Ting; Zhang, Zeng-Lei; Zheng, Rujie

doi:10.1186/s12944-019-1152-y

Cited by 13 publications

(14 citation statements)

References 37 publications

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“…Therefore, an increased level of LDL-C, TC, TG and a decreased level of HDL-C are associated with an increased risk of CAD [11]. A retrospective cohort study found that TG/HDL-C contributed significantly to the prediction of long-term mortality in patients with CAD after undergoing percutaneous coronary intervention [12]. Cigarette smoking causes about 6 million deaths worldwide every year, and CVD accounts for 40% of all the smoking-related deaths [13].…”

Section: Introductionmentioning

confidence: 99%

Mediating effects of lipids on the association between smoking and coronary artery disease risk among Chinese

Song

Guan

et al. 2020

Lipids Health Dis

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Objective: The mechanism between smoking and coronary artery disease (CAD) remains unclear. It is likely that lipid (including triglycerides (TG), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C)) have been functioning as one of the mediators between smoking and the CAD occurrence. The study aimed to investigate the mediating effect of lipid on the relationship between smoking and CAD risk. Methods: The case-control study included 2048 subjects. General linear regression analysis was used to corroborate the association between smoking and lipid levels. Univariate and multivariate logistic regression analysis were performed to reveal the relationship between smoking, lipid and the risk of CAD. Mediation analysis was used to investigate whether the association between smoking and CAD risk was mediated by lipid. Results: Smoking was found to be associated with the risk of CAD (odds ratio (OR) = 1.34, 95% confidence interval (CI): 1.05-1.71, P = 0.019). Regression analysis showed that TG, TC and HDL-C were associated with CAD (OR = 2.69, 95%CI: 2.12-3.40, P < 0.001; OR = 0.34, 95%CI: 0.29-0.43, P < 0.001; OR = 0.37, 95%CI: 0.30-0.47, P < 0.001). Moreover, the ratio of TG to HDL-C (TG/HDL-C) was also related to CAD (OR = 4.45, 95%CI: 3.52-5.64, P < 0.001). Mediation analysis showed that among the effects of smoking on CAD, 17.52% was mediated by lipid, in which HDL-C accounted for 11.16% and TG accounted for 6.36%. Further analysis showed that the effect was also partially mediated by TG/HDL-C, which was accounted for 28%. Conclusions: Lipid plays a partial mediation on the association between smoking and CAD risk. The study provides a clue on the mediation effect of lipids on the relationship between smoking and CAD risks, which is a novel insight to the progression of CAD.

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Section: Introductionmentioning

confidence: 99%

Mediating effects of lipids on the association between smoking and coronary artery disease risk among Chinese

Song

Guan

et al. 2020

Lipids Health Dis

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“…Previous studies have addressed the prognostic role of TG/HDL-C ration in patients with CAD. Studies from wan et al .and Dai et al demonstrated that elevated TG/HDL-C ratio was associated with an increased risk of all-cause mortality in CAD patients after PCI [37,42]. Findings from Matsumoto et al revealed that in statin-treated patients, nonfasting TG/HDL-C ratio was a valuable predictor for cardiovascular events after PCI [39].…”

Section: Discussionmentioning

confidence: 99%

Triglyceride to high-density lipoprotein cholesterol ratio predicts all-cause and cardiovascular mortality in diabetic patients with coronary artery disease on statin treatment

Wang

Cong

Zhang

et al. 2021

Preprint

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Background The triglyceride (TG)to high-density lipoprotein cholesterol (HDL-C) ratio has been regarded as an independent predictor of cardiovascular events. However, the association of TG/HDL-C ratio with survival in patients with diabetes and coronary artery disease (CAD) on statin therapy remains uncertain. The aim of the present study was to explore whether TG/HDL-C ratio predicts mortality in diabetic patients with CAD on statin treatment.Methods A total of 2080 consecutive patients with type 2 diabetes and angiographic-proven CAD who were treated with statin were enrolled in the presents study. Patients were divided into tertiles according to baseline TG/HDL-C ratio. The primary endpoints were all-cause and cardiovascular mortality.Results During 4-year follow-up, 209(10.0%) patients died, 136(65.1%) caused by cardiovascular disease (CVD). The Kaplan-Meier analyses showed that all-cause and cardiovascular mortality increased gradually with rising TG/HDL-C ratio tertiles (log-rank test, P < 0.001, respectively). Multivariate cox hazard regression analysis revealed that patients in tertile 3 but not teretile 2 had significantly higher rate of all-cause and cardiovascular mortality (P < 0.001, P < 0.05, respectively). Moreover, TG/HDL-C ratio was independently associated with all-cause mortality (HR: 1.21, 95% CI:1.11–1.31; P < 0.001) and cardiovascular mortality (HR:1.28, 95% CI: 1.19–1.37; P < 0.001). For all-cause mortality, TG/HDL-C ratio significantly improved the C-statistic (0.799[0.766–0.833] to 0.813[0.780–0.845]; P = 0.018), net reclassification index (NRI) (0.315; P < 0.001), and integrated discrimination index (IDI) (0.012; P = 0.003). For cardiovascular mortality, TG/HDL-C ratio significantly improved the C-statistic (0.769[0.727–0.812] to 0.810[0.771–0.849]; P = 0.001), NRI (0.442; P < 0.001), and IDI (0.039; P < 0.001).Conclusions TG/HDL-C ratio may predict mortality risk among diabetic CAD patients receiving statin treatment. These findings suggest that assessing TG/HDL-C ratio may be useful for risk stratification for mortality risk in patients with diabetes and CAD.

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“…We recorded gender, age, family history of CAD, medications, hypertension, diabetes, smoking, alcohol consumption, systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) as the demographic and clinical data. The definitions of CAD, hypertension, diabetes, smoking and alcohol consumption were described previously [23] . In addition, we collected the laboratory data including…”

Section: Demographic Clinical and Laboratory Characteristicsmentioning

confidence: 99%

“…The secondary endpoints were the composite of major adverse cardiac events (MACEs) defined as cardiac death, heart failure, bleeding events and readmission, and the composite of major adverse cardiac and cerebrovascular events (MACCEs) defined as MACEs combined with stroke. All endpoints were described previously [23] .…”

Section: Endpoints and Follow-upmentioning

confidence: 99%

Alkaline phosphatase-to-albumin ratio as a novel predictor of long-term adverse outcomes in coronary artery disease patients who underwent PCI

et al. 2021

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Background: Alkaline phosphatase (ALP) and albumin (ALB) have been shown to be associated with coronary artery disease (CAD), and it has been reported that alkaline phosphatase-to-albumin ratio (AAR) is associated with the liver damage and poorer prognosis of patients with digestive system malignancy. Moreover, several previous studies showed that there was a higher incidence of malignancy in CAD patients. However, to our knowledge, the relationship between AAR and long-term adverse outcomes in CAD patients after undergoing percutaneous coronary intervention (PCI) has not been investigated. Therefore, we aim to access the relation between AAR and long-term adverse outcomes in post-PCI patients with CAD. Methods: 3378 post-PCI patients with CAD were enrolled in the retrospective CORFCHD-ZZ study from January 2013 to December 2017. The median duration of follow-up was 37.59±22.24 months. The primary endpoint was long-term mortality including all-cause mortality (ACM) and cardiac mortality (CM).The secondary endpoints were major adverse cardiac events (MACEs) and major adverse cardiac and cerebrovascular events (MACCEs). Results: Kaplan-Meier analyses showed that an increased AAR was positively correlated with incidences of long-term ACM (log-rank, P=0.014), CM (log-rank, P=0.011), MACEs (log-rank, P=0.013) and MACCEs (log-rank, P=0.006). Multivariate Cox regression analyses showed that the elevated AAR was an independent predictor of long-term ACM (adjusted HR=1.488 [1.031-2.149], P=0.034), CM (adjusted HR=1.837 [1.141-2.959], P=0.012), MACEs (adjusted HR=1.257 [1.018-1.551], P=0.033) and MACCEs (adjusted HR=1.237 [1.029-1.486], P=0.024). Conclusions: An elevated AAR is a novel independent predictor of long-term adverse outcomes in CAD patients following PCI.

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Triglyceride to high-density lipoprotein cholesterol ratio as a predictor of long-term mortality in patients with coronary artery disease after undergoing percutaneous coronary intervention: a retrospective cohort study

Cited by 13 publications

References 37 publications

Mediating effects of lipids on the association between smoking and coronary artery disease risk among Chinese

Mediating effects of lipids on the association between smoking and coronary artery disease risk among Chinese

Triglyceride to high-density lipoprotein cholesterol ratio predicts all-cause and cardiovascular mortality in diabetic patients with coronary artery disease on statin treatment

Alkaline phosphatase-to-albumin ratio as a novel predictor of long-term adverse outcomes in coronary artery disease patients who underwent PCI

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