Zhou Shangxun, Qiu Miaohan, Wang Kexin, Li Jing, Li Yi, Han Yaling
State Key Laboratory of Frigid Zone Cardiovascular Disease, Cardiovascular Research Institute, Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, 110016, China.
The Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi'an, China.
Sci Rep. 2024 Dec 30;14(1):31752. doi: 10.1038/s41598-024-82064-9.
The triglyceride to high density lipoprotein cholesterol (TG/HDL-C) ratio has been consistently linked with the risk of coronary heart disease (CHD). Nevertheless, there is a paucity of studies focusing on acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) or experiencing bleeding events. The study encompassed 17,643 ACS participants who underwent PCI. Survival analysis, Cox regression analysis and restricted cubic spline (RCS) were employed to assess the associations between TG/HDL-C ratio and the risk of major adverse cardiovascular events (MACE), all-cause death, cardiac death and all-cause bleeding events. Over a 12-month follow-up period, 638 (3.9%) patients experienced MACE while 2837 (16.1%) patients experienced bleeding events. The TG/HDL-C ratio exhibited significant positive correlations with the incidence of MACE, all-cause death and cardiac death; conversely it displayed significant negative correlations with the incidence of all-cause bleeding. Patients in the high quartile TG/HDL-C category demonstrated significantly higher risks for MACE compared to those in the low quartile category, with hazard ratio (HR) [95%confidence interval (CI)] of 1.46 (1.17-1.83); conversely, they showed significantly lower risks for all-cause bleeding compared to their counterparts in the low quartile group, with HR (95%CI) of 0.72 (0.65-0.81). The structure of subgroup analyses remained robust and consistent, with gender being the sole factor interacting with TG/HDL-C specifically in relation to MACE events (P for interaction = 0.037). A higher baseline TG/HDL-C ratio was associated with an elevated risk of MACE but a reduced risk of bleeding events in ACS patients undergoing PCI.
甘油三酯与高密度脂蛋白胆固醇（TG/HDL-C）的比值一直与冠心病（CHD）风险相关。然而，针对接受经皮冠状动脉介入治疗（PCI）或发生出血事件的急性冠状动脉综合征（ACS）患者的研究却很少。该研究纳入了17643例接受PCI的ACS参与者。采用生存分析、Cox回归分析和限制立方样条（RCS）来评估TG/HDL-C比值与主要不良心血管事件（MACE）、全因死亡、心源性死亡和全因出血事件风险之间的关联。在12个月的随访期内，638例（3.9%）患者发生了MACE，而2837例（16.1%）患者发生了出血事件。TG/HDL-C比值与MACE、全因死亡和心源性死亡的发生率呈显著正相关；相反，它与全因出血的发生率呈显著负相关。与低四分位数组相比，高四分位数TG/HDL-C组的患者发生MACE的风险显著更高，风险比（HR）[95%置信区间（CI）]为1.46（1.17 - 1.83）；相反，与低四分位数组的患者相比，他们发生全因出血的风险显著更低，HR（95%CI）为0.72（0.65 - 0.81）。亚组分析的结构保持稳健且一致，性别是唯一与TG/HDL-C在MACE事件方面有特定相互作用的因素（交互作用P值 = 0.037）。较高的基线TG/HDL-C比值与接受PCI的ACS患者发生MACE的风险升高相关，但与出血事件的风险降低相关。
