Shi Dongdong, Wang Le, Cong Hongliang
Clinical College of Thoracic Medicine, Tianjin Medical University, 300070 Tianjin, China.
Department of Cardiology, Tianjin Chest Hospital, 300222 Tianjin, China.
Rev Cardiovasc Med. 2022 May 26;23(6):190. doi: 10.31083/j.rcm2306190. eCollection 2022 Jun.
The incidence of diabetes mellitus has reached an alarming level. Cardiovascular disease (CVD) is the leading cause of mortality in diabetic patients. However, the association between ratio and survival outcomes in patients with diabetes mellitus (DM) and new-onset acute coronary syndrome (ACS) remains unknown. This study aimed to assess the association between the TG/HDLC ratio and the risk of death in diabetic patients with new-onset acute coronary syndrome in the Han Chinese population.
Data in this study were retrospectively collected from January 2016 to December 2016 from patients with type 2 diabetes mellitus (T2DM) and new-onset ACS in Tianjin Chest Hospital. Patients were classified according to the baseline TG/HDLC ratio. Kaplan-Meier survival curves were used to demonstrate survival outcomes. Univariate and multivariate Cox proportional risk regression analyses were used to evaluate the hazard ratios and 95% confidence intervals (CIs) for the risk of death. Subgroup analysis was used to determine the presence of any interaction.
In total, 152 patients died, 98 of them from heart disease. The Kaplan-Meier survival curve showed that there were no significant differences for both all-cause and cardiac mortality between Median 1 and Median 2 in log-rank test. Multivariate Cox regression analyses revealed that the adjusted hazard ratio increased significantly ( 0.05) with increasing median TG/HDLC for not only all-cause mortality and cardiac death, but also nonfatal stroke, fatal stroke and fatal MI. The association between the TG/HDLC ratio and the risks of all-cause mortality and cardiac death in diabetic patients with new-onset ACS was similar among subgroups ( 0.05).
An elevated TG/HDLC ratio (TG/HDLC 1.522) is associated with an increased risk of all-cause and cardiac death risks in diabetic patients with new-onset ACS. Therefore, TG/HDLC ratio may be a beneficial parameter to evaluate the prognosis of this high-risk population.
糖尿病的发病率已达到令人担忧的水平。心血管疾病（CVD）是糖尿病患者死亡的主要原因。然而，糖尿病（DM）合并新发急性冠状动脉综合征（ACS）患者的该比值与生存结局之间的关联仍不清楚。本研究旨在评估汉族人群中糖尿病合并新发急性冠状动脉综合征患者的甘油三酯/高密度脂蛋白胆固醇（TG/HDLC）比值与死亡风险之间的关联。
本研究数据回顾性收集自2016年1月至2016年12月在天津胸科医院就诊的2型糖尿病（T2DM）合并新发ACS患者。根据基线TG/HDLC比值对患者进行分类。采用Kaplan-Meier生存曲线来展示生存结局。单因素和多因素Cox比例风险回归分析用于评估死亡风险的风险比和95%置信区间（CIs）。亚组分析用于确定是否存在任何交互作用。
总共152例患者死亡，其中98例死于心脏病。Kaplan-Meier生存曲线显示，对数秩检验中，中位数1和中位数2之间的全因死亡率和心脏死亡率均无显著差异。多因素Cox回归分析显示，不仅全因死亡率和心脏死亡，而且非致死性卒中、致死性卒中和致死性心肌梗死的调整后风险比均随着中位数TG/HDLC的升高而显著增加（P<0.05）。亚组之间，TG/HDLC比值与糖尿病合并新发ACS患者的全因死亡率和心脏死亡风险之间的关联相似（P>0.05）。
升高的TG/HDLC比值（TG/HDLC>1.522）与糖尿病合并新发ACS患者的全因死亡和心脏死亡风险增加相关。因此，TG/HDLC比值可能是评估这一高危人群预后的有益参数。
