Triglycerides and low HDL cholesterol predict coronary heart disease risk in patients with stable angina

Caselli, C.; Caterina, Raffaele De; Smit, Jeff M.; Campolo, Jonica; Mahdiui, Mohammed El; Ragusa, Rosetta; Clemente, Alberto; Sampietro, Tiziana; Clerico, Aldo; Liga, Riccardo; Pelosi, Gualtiero; Rocchiccioli, Silvia; Parodi, Oberdan; Scholte, Arthur J.; Knuuti, Juhani; Neglia, Danilo; Evinci,; Smartool,

doi:10.1038/s41598-021-00020-3

Cited by 33 publications

(31 citation statements)

References 39 publications

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“…It was suggested that the TG/HDL-C ratio could be used as an indicator of LDL subfraction [ 29 ]. In addition, TG/HDL-C ratio increases systemic and vascular inflammatory processes by decreasing endothelial protective mechanisms, which leads to progressive coronary atherosclerosis [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Plasma atherogenic indices are independent predictors of slow coronary flow

Afşin

Kaya

Süner

et al. 2021

BMC Cardiovasc Disord

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Background Although the pathophysiology of coronary slow flow (CSF) has not been fully elucidated, emerging data increasingly support potential role for subclinical diffuse atherosclerosis in the etiology of CSF. We aimed to investigate relationship between atherogenic indices and CSF. Methods 130 patients with CSF diagnosed according to Thrombolysis in Myocardial Infarction (TIMI)-frame count (TFC) method and 130 controls who had normal coronary flow (NCF) were included in this retrospective study. Atherogenic indices (atherogenic index of plasma [AIP], Castelli risk indices I and II [CRI-I and II]) were calculated using conventional lipid parameters. Results The logistic regression analyses demonstrated that AIP (OR, 5.463; 95% confidence interval [CI], 1.357–21.991; p = 0.017) and CRI-II (OR, 1.624; 95% CI, 1.138–2.319; p = 0.008) were independent predictors of CSF. Receiver operating characteristic analysis showed that the optimal cutoff value to predict the occurrence of CSF was 0.66 for AIP (sensitivity, 59%; specificity, 73%; area under curve [AUC], 0.695; p < 0.001) and 3.27 for CRI-II (sensitivity, 60%; specificity, 79%; AUC, 0.726; p < 0.001). Conclusions AIP and CRI-II levels were independent predictors of CSF. Prospective studies in larger cohorts of patients may elucidate the role of atherogenic dyslipidemia in the pathophysiology of CSF.

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Section: Discussionmentioning

confidence: 99%

Plasma atherogenic indices are independent predictors of slow coronary flow

Afşin

Kaya

Süner

et al. 2021

BMC Cardiovasc Disord

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“…Recently, in a prospective, multicenter study enrolling 355 patients with stable angina at intermediate-low risk referred to coronary computed tomography angiography (CTA) and followed for 4.5 years, patients with a higher TG/HDL-C ratio presented a higher coronary atherosclerosis burden ( 21 ). In addition, both a higher TG/HDL-C ratio and the coronary CTA score were additional predictors of worse outcome, independently of other cardiovascular risk factors, the presence of obstructive CAD or ischemia ( 21 ). In contrast to these controlled studies, VHR CCS patients included in our registry were undertreated with statin therapies and were followed up for a short period of time.…”

Section: Discussionmentioning

confidence: 99%

Clinical Impact and Prognostic Role of Triglyceride to High-Density Lipoprotein Cholesterol Ratio in Patients With Chronic Coronary Syndromes at Very High Risk: Insights From the START Study

Luca¹,

Temporelli

Colivicchi

et al. 2022

Front. Cardiovasc. Med.

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BackgroundSeveral studies have reported that the combination of high TG and low HDL-C, as simplified by the TG/HDL-C ratio, was a predictor of cardiovascular disease independent of LDL-C level. Nevertheless, poor data are available on the predictive role of TG/HDL-C ratio in very high risk (VHR) patients with chronic coronary syndromes (CCS).MethodsUsing the data from the STable Coronary Artery Diseases RegisTry (START) study, an Italian nationwide registry, we assessed the association between the TG/HDL-C ratio and baseline clinical characteristics, pharmacological treatment, and major adverse cardio-cerebrovascular events (MACCE) at 1 year in a large cohort of CCS patients at VHR.ResultsVHR patients with both TG and HDL-C levels available were grouped in tertiles of TG/HDL-C ratio: low (TG/HDL-C ratio <2, n = 967), middle (TG/HDL-C ratio 2–3.3, n = 1,071) and high (TG/HDL-C ratio >3.3, n = 1,028). At 1 year from enrolment, 232 (7.6%) patients presented a MACCE, with a higher incidence in the higher tertile, even though not statistically significant (6.0, 8.2, and 8.4% in the low, middle and high tertile, respectively; p = 0.08). At multivariable analysis, the TG/HDL-C ratio in tertiles did not result an independent predictor of the MACCE (p = 0.29) at 1-year follow-up (HR: 1.30; 95% CI: 0.93–1.82; p = 0.12 middle vs. lower tertile, and HR: 1.22; 95% CI: 0.87–1.72; p = 0.25 higher vs. lower).ConclusionsIn the present large, nationwide cohort of CCS patients at VHR a high TG/HD ratio did not emerge as independent predictor of MACCE at 1 year. Further studies with a longer follow-up are needed to better define the prognostic role of TG/HDL ratio in CCS.

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“…From a clinical point of view, the results of our analyses highlight the potentiality of measuring lipid species as new biomarkers of evolving atherosclerotic risk and to guide clinical management and target specific treatments in patients with CCS. In these patients, the identification of a specific condition of residual CAD risk not tackled by current treatments is a relevant clinical unmet need [12,44] and a potential target of new treatments [12,45].…”

Section: Discussionmentioning

confidence: 99%

“…In particular, in a European multicenter population of stable patients with CCS, highest TG/ HDL-C ratio highlights a specific lipid species signature able to identify patients with higher CAD risk. The research of new molecular pathways has a pivotal importance in the fight against residual risk, and in development of new targeted nutritional, lifestyle and drug strategies beyond the established LDL-C lowering interventions [12,45]. Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the remarkable progress in pharmacological and interventional treatments, CAD remains a major cause of death [1] also due to "residual risk" associated with specific cardiometabolic profiles, which is not tackled by current treatments. High triglyceride and low high-density lipoprotein cholesterol levels, as simplified by the TG/HDL-C ratio, identify one of this emerging cardiometabolic risk profiles characterized by insulin-resistance, obesity and metabolic syndrome known to be associated with angiographically documented CAD [2][3][4][5][6][7][8][9][10][11] and CAD related outcomes [12].…”

Section: Introductionmentioning

confidence: 99%

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A specific plasma lipid signature associated with high triglycerides and low HDL cholesterol identifies residual CAD risk in patients with chronic coronary syndrome

et al. 2021

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Background and aims: Elevated triglycerides (TG) and low high-density lipoprotein cholesterol (HDL-C) define a specific lipid profile associated with residual coronary artery disease (CAD) risk independently of total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels. Aim of the present study was to assess whether TG/ HDL-C ratio, coronary atherosclerosis and their change over time are characterized by a specific lipidomic profiling in stable patients with chronic coronary syndrome (CCS). Methods: TG/HDL-C ratio was calculated in 193 patients (57.8 ± 7.6 years, 115 males) with CCS characterized by clinical, bio-humoral profiles and cardiac imaging. Patient-specific plasma targeted lipidomics was defined through a high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) strategy. Patients underwent coronary computed tomography angiography (CTA) and an individual CTA risk score, combining extent, severity, composition, and location of plaques, was calculated. All patients entered a follow-up (6.39 ± 1.17 years), including clinical, lipidomics and coronary CTA assessments. Results: Patients were divided in groups according to baseline TG/HDL-C quartiles: IQ (<1.391), IIQ (1.392-2.000), IIIQ (2.001-3.286), and IVQ (≥3.287). A specific pattern of altered lipids, characterized by reduced plasma levels of cholesterol esters, phosphatidylcholines and sphingomyelins, was associated with higher TG/HDL-C both at baseline and follow-up (IVQ vs IQ). The CTA risk score increased over time and this lipid signature was also associated with higher CTA score at follow-up. Conclusions: In stable CCS, a specific lipidomic signature identifies those patients with higher TG/HDL-C ratio and higher CTA score over time, suggesting possible molecular pathways of residual CAD risk not tackled by current optimal medical treatments.

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Triglycerides and low HDL cholesterol predict coronary heart disease risk in patients with stable angina

Cited by 33 publications

References 39 publications

Plasma atherogenic indices are independent predictors of slow coronary flow

Plasma atherogenic indices are independent predictors of slow coronary flow

Clinical Impact and Prognostic Role of Triglyceride to High-Density Lipoprotein Cholesterol Ratio in Patients With Chronic Coronary Syndromes at Very High Risk: Insights From the START Study

A specific plasma lipid signature associated with high triglycerides and low HDL cholesterol identifies residual CAD risk in patients with chronic coronary syndrome

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