高甘油三酯与高密度脂蛋白胆固醇比值预示新发心力衰竭预后不良：一项回顾性研究。

High triglyceride-to-high-density lipoprotein cholesterol ratio predicts poor prognosis in new-onset heart failure: a retrospective study.

作者信息

Weng Junfei, Dong Wei, Liao Ruichun, Zheng Yaofu, Fang Xu, You Jiaxiang, Wang Zhichao, Zuo Yingbing, Chen Xuanying, Peng Xiaoping

机构信息

The 1 st affiliated hospital, Jiangxi Medical College, Nanchang University, No. 461, Bayi Avenue, Nanchang City, 330006, Jiangxi Province, People's Republic of China.

The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17, Yongwaizheng Street, Donghu District, Nanchang City, 330006, Jiangxi Province, People's Republic of China.

出版信息

BMC Cardiovasc Disord. 2025 Apr 2;25(1):251. doi: 10.1186/s12872-025-04706-8.

DOI:10.1186/s12872-025-04706-8

PMID:40175907

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11963554/

Abstract

BACKGROUND

There is limited research on the relationship between the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio and outcomes in new-onset heart failure (HF). Therefore, this study aimed to explore the association between TG/HDL-C ratio and clinical outcomes in these patients.

METHODS

A retrospective cohort of 614 adults with new-onset HF hospitalized at The First Affiliated Hospital of Nanchang University between July 2021 and December 2022 was analyzed. The primary endpoint was major adverse cardiovascular events (MACE), defined as cardiovascular (CV) death and HF rehospitalizations within 12 months after discharge. Kaplan-Meier (K-M) curves, restricted cubic spline (RCS) analysis, and Cox regression evaluated the association between TG/HDL-C ratio and MACE risk.

RESULTS

Patients were divided into four quartiles (Quartile 1, 2,3 and 4) based on their TG/HDL-C ratios. The mean age was 68.94 ± 14.34 years, with 59.12% male. The mean left ventricular ejection fraction (LVEF) was 46.59 ± 10.89%, with 45.11% having an LVEF ≤ 40%. During the 12-month follow-up, 156 patients experienced MACE, comprising 18 CV deaths and 138 HF rehospitalizations. The Quartile 4 group had the highest MACE risk incidence compared to other groups (P < 0.001). K-M analysis confirmed that the Quartile 4 group was associated with an increased cumulative incidence of MACE, HF rehospitalization, and CV death (all P < 0.001). RCS analysis revealed a positive nonlinear relationship between the TG/HDL-C ratio and MACE risk (P for nonlinear = 0.026), with a sharp risk increase above a ratio of 1.08. After adjustment, TG/HDL-C ratio was independently associated with MACE (HR: 1.44, 95% CI: 1.29-1.60). Compared to Quartile 1, adjusted HRs were significantly higher in Quartiles 2, 3, and 4 (all P < 0.005).

CONCLUSIONS

The TG/HDL-C ratio is independently associated with 12-month MACE risk in new-onset HF patients. It may serve as a simple, cost-effective marker to improve early risk stratification and guide closer monitoring and tailored management in this high-risk population.

摘要

背景

关于甘油三酯与高密度脂蛋白胆固醇（TG/HDL-C）比值与新发心力衰竭（HF）预后之间的关系，研究有限。因此，本研究旨在探讨这些患者中TG/HDL-C比值与临床预后之间的关联。

方法

分析了2021年7月至2022年12月在南昌大学第一附属医院住院的614例新发HF成年患者的回顾性队列。主要终点是主要不良心血管事件（MACE），定义为出院后12个月内的心血管（CV）死亡和HF再住院。采用Kaplan-Meier（K-M）曲线、限制性立方样条（RCS）分析和Cox回归评估TG/HDL-C比值与MACE风险之间的关联。

结果

根据TG/HDL-C比值将患者分为四个四分位数（四分位数1、2、3和4）。平均年龄为68.94±14.34岁，男性占59.12%。平均左心室射血分数（LVEF）为46.59±10.89%，45.11%的患者LVEF≤40%。在12个月的随访期间，156例患者发生MACE，包括18例CV死亡和1次138次HF再住院。与其他组相比，四分位数4组的MACE风险发生率最高（P<0.001）。K-M分析证实，四分位数4组与MACE、HF再住院和CV死亡的累积发生率增加相关（所有P<0.001）。RCS分析显示TG/HDL-C比值与MACE风险之间存在正非线性关系（非线性P=0.026），当比值高于1.08时风险急剧增加。调整后，TG/HDL-C比值与MACE独立相关（HR：1.44，95%CI：1.29-1.60）。与四分位数1相比，四分位数2、3和4的调整后HR显著更高（所有P<0.005）。