News
Article
Investigators Find Triglyceride/High Density Lipoprotein Cholesterol Ratio Is Significantly Associated With MACE
Author(s):
Key Takeaways
- TG/HDL-C ratio is linked to increased MACE risk in ACS patients post-PCI, especially in the highest quartile.
- Elevated TG/HDL-C levels correlate with younger age, male sex, and cardiovascular risk factors.
Patients with acute coronary syndrome who were in the high quartile were at significantly higher risk for major adverse cardiovascular events (MACE).
Triglyceride to high density lipoprotein cholesterol (TG/HDL-C) ratio showed significant associations with the incidence of major adverse cardiovascular events (MACE), all-cause death, and cardiac death. In findings published in Scientific Reports, patients with acute coronary syndrome (ACS) who were in the highest quartile TG/HDL-C category were at significantly higher risk for MACE compared with those in the lowest quartile category.1
Triglyceride, Density Lipoprotein Cholesterol, MACE, Major Cardiovascular Events | Image Credit: © jarun011 | stock.adobe.com
ACS usually begins suddenly and can include a range of conditions that are related to reduced blood flow to the heart, including heart attack and unstable angina. It can be accompanied by chest pain or discomfort, pain that starts in the chest and spreads to other parts of the body, nausea or vomiting, indigestion, dyspnea, heavy sweating, racing heartbeat, and feeling lightheaded or dizzy. Risk factors can include older age; high blood pressure; high blood cholesterol; smoking tobacco; lack of physical activity; obesity or overweight; diabetes; family history of chest pain, heart attack, or stroke; or history of high blood pressure, preeclampsia, or diabetes during pregnancy and early menopause.2
According to the study authors, after patients undergo standardized percutaneous coronary intervention (PCI), they should receive guideline-directed pharmacotherapy for ACS to optimize the prognosis. However, the prognostic outcomes for patients with ACS who undergo PCI can vary due to demographic parameters, hematological markers, medication utilization, and medical history. PCI, according to StatPearls, is a non-surgical invasive procedure to relieve narrowing of coronary artery and improving blood supply to ischemic tissue. It has been used extensively over the past few years, and 80% of PCI is done with stents. It has also shown reductions in short-term mortality, heart attack, and targeted vessel revascularization (TVR).1,3
In the current study, investigators aimed to predict the risk of ischemic and bleeding events in patients with ACS post-PCI, specifically with TG/HDL-C ratio. They hope the results could aid in the decision-making of antiplatelet therapy and preventing cardiovascular adverse events.1
Investigators compiled data from patients in the General Hospital of Northern Theater Command, China, enrolling 17,643 patients with ACS who underwent PCI between March 2016 and March 2019. Patients included had unstable angina, non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction. Investigators were followed for a 12-month period. The primary outcome included MACE, cardiac death, nonfatal myocardial infarction stroke, and target vessel revascularization within 12 months post-discharge. Secondary outcomes included all-cause mortality, cardiac death, and all-cause bleeding events within 1 year.1
Approximately 73% of individuals were male and there was a mean age of 60.77 years. The prevalence of hypertension and diabetes were 62% and 31.1%, respectively. Elevated TG/HDL-C levels were associated with younger age, male sex, current smoking status, prior myocardial infarction, hypertension, and diabetes. It was also linked to a higher incidence of NSTEMI and greater usage of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and beta-blockers. In the follow-up period, MACE occurred in 638 individuals, with 1.1% experiencing cardiac death, 0.5% nonfatal myocardial infarction, 0.6% stroke, and 1.9% TVR.1
Investigators found a significant correlation between continuous TG-HDL-C ratio and an elevated risk of MACE, all-cause death, and cardiac death, but a decreased risk of all-cause bleeding. There was an elevated cumulative risk of MACE in the fourth quartile compared with the first quartile, and all-cause bleeding was lower in the fourth quartile compared with the first. There were no significant outcomes for risk in all-cause deaths or cardiac deaths. In the subgroup analyses, TG/HDL-C ratio was associated with gender, with the fourth quartile increasing the risk of MACE by 46% compared with first quartile for the full population, but by 84% for women.1
