Abstract 13807: The Triglyceride to High-Density Lipoprotein Cholesterol Ratio Predicts Coronary Artery Disease in Non-Diabetic Individuals
Introduction: Insulin resistance is a risk factor for coronary artery disease (CAD) and is associated with a characteristic pro-atherogenic dyslipidemia. The triglyceride/high-density lipoprotein cholesterol (TG:HDLC) ratio has been shown to be a good surrogate marker of insulin resistance, which develops before Type II Diabetes Mellitus is diagnosed. Given this, it may be clinically useful to have a means to identify non-diabetics with coronary disease.
Hypothesis: We assessed the hypothesis that a high TG:HDLC ratio predicts coronary artery disease in high-risk cardiovascular patients without Type II Diabetes Mellitus.
Methods: We analyzed 614 non-diabetic individuals from the larger BRAVEHEART Cohort Study presenting for coronary angiography. Cardiac risk factors were assessed, and fasting insulin, fasting blood glucose, glycated hemoglobin and a full lipid panel were collected. A TG:HDLC ratio was measured in 594 patients. Patients were categorized according to 1) the presence or absence of CAD, and 2) 0 vessel (CAD absent), 1&2 vessel, or 3 vessel disease.
Results: The mean TG:HDLC ratio was greater in those with CAD than those without (1.61±0.06 [standard error], 95% confidence interval [CI] 1.49-1.73 vs. 1.20±0.05, 95% CI 1.10-1.30; p=0.0001). Compared to 0-vessel disease, both 1&2 and 3-vessel groups had a higher mean TG:HDLC (1.20±0.05 vs. 1.60±0.1 95% CI 1.40-1.80 & 1.62±0.06, 95% CI 1.49-1.79 respectively; p<0.0008). There was no statistical difference in the mean TG:HDLC between 1&2 and 3-vessel disease (p=0.1596). Logistic regression analysis showed that the TG:HDLC ratio was a statistically significant predictor of the presence of any CAD (Odds Ratio [OR]=1.83±0.33; 95% CI 1.28-2.59, p=0.001) adjusted for statin use, lipids, glycemic markers, insulin and cardiac risk factors.
Conclusion: In conclusion, these results suggest that the TG:HDLC ratio positively predicts CAD in non-diabetic individuals presenting for angiography independent of statin use, lipids, glucose and insulin levels, and cardiac risk factors. Although these results show potential for clinical application, further studies are warranted to investigate whether the TG: HDL ratio will be useful to screen high-risk patients.
Author Disclosures: J. Gin: None. N. Yap: None. A. Nguyen: None. H. Adams: None. A. Wilson: None.
- © 2014 by American Heart Association, Inc.