Elevated TG/HDL-C ratio is an independent predictor of outcome and it is associated with CAD progression in patients with stable coronary artery disease

Autor: Juhani Knuuti, Gualtiero Pelosi, R.R. Buechel, Massimo Magnacca, Danilo Neglia, R Rosendael, Jeff M. Smit, Arthur J.H.A. Scholte, M N Pizzi, Oberdan Parodi, Anna Teresinska, J Campolo, Chiara Caselli, Silvia Rocchiccioli, Rosetta Ragusa
Rok vydání: 2020
Předmět:
Zdroj: European Heart Journal. 41
ISSN: 1522-9645
0195-668X
DOI: 10.1093/ehjci/ehaa946.1503
Popis: Background Elevated TG/HDL-C ratio is associated with CVD outcomes in high-risk populations presenting for coronary angiography, but studies were limited in gender-specific populations or in pts with ACS. Purpose Aim of this study was to evaluate the prognostic role of TG/HDL-C levels and their association with CAD progression in pts with suspected stable CAD. Methods TG/HDL-C ratio was calculated in 545 pts (60±9yrs,330males) with symptoms of stable CAD enrolled in the EVINCI study. 490 pts underwent coronary CTA to assess the presence of CAD (>50%stenosis) and entered a clinical follow up (4.5±0.9yrs). The CVD outcome measure included all cause mortality, non fatal MI, hospitalization for unstable angina or HF. After 6±1yrs, during the SMARTool study, a second CTA was obtained in 171 EVINCI pts and a CTA risk score (based on plaque extent, severity, composition, and location) was calculated at enrolment and at follow up to assess CAD progression (ΔCTA score). Results Pts were divided according to TG/HDL-C quartiles: IQ (3.33). As reported in Table, the frequency of male, diabetes, metabolic syndrome and obesity increased among quartiles. Glucidic biomarkers progressively increased from quartile I to IV, while LDL-C decreased. The prevalence of obstructive CAD at CTA did not differ among groups. The CVD endpoint occurred in 7% of pts. At multivariable analyses, high TG/HDL-C ratio (IVQ) was associated with the outcome endpoint independently from presence of obstructive CAD and treatment (HR 3.477, 95% CI 1.181–10.239, P=0.0237). CTA score was significantly higher in pts in IVQ compared to IQ at both SMARTool enrolment and follow up (Figure1). A significantly higher ΔCTA score was observed in pts in III-IVQ compared with those in I-IIQ (Figure2). Conclusion Elevated TG/HDL-C ratio is an independent predictor of outcome and it is associated with CAD progression in patients with stable CAD. Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): “EValuation of INtegrated Cardiac Imaging” - EVINCI [GA number: 222915]; “Simulation Modeling of coronary ARTery disease: a tool for clinical decision support - SMARTool” [GA number: 689068]
Databáze: OpenAIRE
Externí odkaz: