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Lipids Health Dis. 2019 Dec 4;18(1):210. doi: 10.1186/s12944-019-1152-y.

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 XY1,2, Zheng YY3,4, Tang JN1,2, Yang XM5, Guo QQ1,2, Zhang JC1,2, Cheng MD1,2, Song FH1,2, Liu ZY1,2, Wang K1,2, Jiang LZ1,2, Fan L1,2, Yue XT1,2, Bai Y1,2, Zhang ZL1,2, Zheng RJ1,2, Zhang JY6,7.

Author information

1
Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People's Republic of China.
2
Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, 450052, People's Republic of China.
3
Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People's Republic of China. zhengying527@163.com.
4
Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, 450052, People's Republic of China. zhengying527@163.com.
5
Department of Cardiology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, 471003, People's Republic of China.
6
Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People's Republic of China. jyzhang@zzu.edu.cn.
7
Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, 450052, People's Republic of China. jyzhang@zzu.edu.cn.

Abstract

BACKGROUND:

It has been confirmed that the triglyceride to high-density lipoprotein cholesterol ratio (THR) is associated with insulin resistance and metabolic syndrome. However, to the best of our knowledge, only a few studies with small sample sizes have investigated the relationship between THR and coronary artery disease (CAD). Therefore, we aimed to assess the correlation between the THR and long-term mortality in patients with CAD after undergoing percutaneous coronary intervention (PCI) in our study that enrolled a large number of patients.

METHODS:

A total of 3269 post-PCI patients with CAD were enrolled in the CORFCHD-ZZ study from January 2013 to December 2017. The mean follow-up time was 37.59 ± 22.24 months. Patients were divided into two groups according to their THR value: the lower group (THR < 2.84, n = 1232) and the higher group (THR ≥ 2.84, n = 2037). 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:

In our study, ACM occurred in 124 patients: 30 (2.4%) in the lower group and 94 (4.6%) in the higher group (P = 0.002). MACEs occurred in 362 patients: 111 (9.0%) in the lower group and 251 (12.3%) in the higher group (P = 0.003). The number of MACCEs was 482: 152 (12.3%) in the lower group and 320 (15.7%) in the higher group (P = 0.008). Heart failure occurred in 514 patients: 89 (7.2%) in the lower group and 425 (20.9%) in the higher group (P < 0.001). Kaplan-Meier analyses showed that elevated THR was significantly related to long-term ACM (log-rank, P = 0.044) and the occurrence of heart failure (log-rank, P < 0.001). Multivariate Cox regression analyses showed that the THR was an independent predictor of long-term ACM (adjusted HR = 2.042 [1.264-3.300], P = 0.004) and heart failure (adjusted HR = 1.700 [1.347-2.147], P < 0.001).

CONCLUSIONS:

An increased THR is an independent predictor of long-term ACM and heart failure in post-PCI patients with CAD.

KEYWORDS:

All-cause mortality; Coronary artery disease; Percutaneous coronary intervention; Triglyceride to high-density lipoprotein cholesterol ratio

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