Abstract
BackgroundIt 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.MethodsA 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).ResultsIn 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).ConclusionsAn increased THR is an independent predictor of long-term ACM and heart failure in post-PCI patients with CAD.
Highlights
It has been confirmed that the triglyceride to high-density lipoprotein cholesterol ratio (THR) is associated with insulin resistance and metabolic syndrome
An increased THR is an independent predictor of long-term all-cause mortality (ACM) and heart failure in post-percutaneous coronary intervention (PCI) patients with coronary artery disease (CAD)
To our knowledge, there have been only a few studies reporting that the THR had a significant relationship with the extent of the lesion [13], cardiovascular events [14] and long-term ACM [15] in patients with CAD, whereas the sample sizes of these studies were small; none were more than 500 subjects
Summary
It has been confirmed that the triglyceride to high-density lipoprotein cholesterol ratio (THR) is associated with insulin resistance and metabolic syndrome. To our knowledge, there have been only a few studies reporting that the THR had a significant relationship with the extent of the lesion [13], cardiovascular events [14] and long-term ACM [15] in patients with CAD, whereas the sample sizes of these studies were small; none were more than 500 subjects. Sultani R et al [15] performed a study in which a high THR independently predicted long-term ACM in 482 CAD patients who underwent coronary angiography without PCI.
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