Wan Ke, Zhao Jianxun, Huang Hao, Zhang Qing, Chen Xi, Zeng Zhi, Zhang Li, Chen Yucheng
Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P. R. China.
Division of Cardiology, the People's Hospital of Sichuan Province, Chengdu, Sichuan, China.
PLoS One. 2015 Apr 16;10(4):e0123521. doi: 10.1371/journal.pone.0123521. eCollection 2015.
High triglycerides (TG) and low high-density lipoprotein cholesterol (HDL-C) are cardiovascular risk factors. A positive correlation between elevated TG/HDL-C ratio and all-cause mortality and cardiovascular events exists in women. However, utility of TG to HDL-C ratio for prediction is unknown among acute coronary syndrome (ACS).
Fasting lipid profiles, detailed demographic data, and clinical data were obtained at baseline from 416 patients with ACS after coronary revascularization. Subjects were stratified into three levels of TG/HDL-C. We constructed multivariate Cox-proportional hazard models for all-cause mortality over a median follow-up of 3 years using log TG to HDL-C ratio as a predictor variable and analyzing traditional cardiovascular risk factors. We constructed a logistic regression model for major adverse cardiovascular events (MACEs) to prove that the TG/HDL-C ratio is a risk factor.
The subject's mean age was 64 ± 11 years; 54.5% were hypertensive, 21.8% diabetic, and 61.0% current or prior smokers. TG/HDL-C ratio ranged from 0.27 to 14.33. During the follow-up period, there were 43 deaths. In multivariate Cox models after adjusting for age, smoking, hypertension, diabetes, and severity of angiographic coronary disease, patients in the highest tertile of ACS had a 5.32-fold increased risk of mortality compared with the lowest tertile. After adjusting for conventional coronary heart disease risk factors by the logistic regression model, the TG/HDL-C ratio was associated with MACEs.
The TG to HDL-C ratio is a powerful independent predictor of all-cause mortality and is a risk factor of cardiovascular events.
高甘油三酯（TG）和低高密度脂蛋白胆固醇（HDL-C）是心血管危险因素。女性中，TG/HDL-C比值升高与全因死亡率和心血管事件之间存在正相关。然而，在急性冠状动脉综合征（ACS）中，TG与HDL-C比值用于预测的效用尚不清楚。
在基线时从416例冠状动脉血运重建术后的ACS患者中获取空腹血脂谱、详细的人口统计学数据和临床数据。将受试者分为TG/HDL-C的三个水平。我们构建了多变量Cox比例风险模型，以log TG与HDL-C比值作为预测变量并分析传统心血管危险因素，对3年中位随访期内的全因死亡率进行研究。我们构建了一个逻辑回归模型用于主要不良心血管事件（MACE），以证明TG/HDL-C比值是一个危险因素。
受试者的平均年龄为64±11岁；54.5%为高血压患者，21.8%为糖尿病患者，61.0%为当前吸烟者或既往吸烟者。TG/HDL-C比值范围为0.27至14.33。在随访期间，有43例死亡。在多变量Cox模型中，在调整年龄、吸烟、高血压、糖尿病和冠状动脉造影疾病严重程度后，ACS最高三分位数的患者与最低三分位数相比，死亡风险增加了5.32倍。通过逻辑回归模型调整传统冠心病危险因素后，TG/HDL-C比值与MACE相关。
TG与HDL-C比值是全因死亡率的有力独立预测指标，也是心血管事件的危险因素。
