Triglycerides and low HDL cholesterol predict coronary heart disease risk in patients with stable angina

Area of Science:

• Cardiology
• Lipid Metabolism
• Atherosclerosis Research

Background:

• Stable angina patients often have dyslipidemia, impacting coronary atherosclerotic disease (CAD) progression.
• The TG/HDL-C ratio is a marker of dyslipidemia, but its predictive value for CAD outcomes in stable angina needs further clarification.
• Existing lipid-lowering strategies primarily focus on LDL-C, potentially overlooking the role of TG and HDL-C.

Purpose of the Study:

• To evaluate the association between the TG/HDL-C ratio and coronary atherosclerotic disease (CAD) outcomes in patients with stable angina.
• To identify independent predictors of CAD progression and adverse cardiovascular events in this patient cohort.
• To assess whether the TG/HDL-C ratio predicts outcomes independently of LDL-C and other established risk factors.

Main Methods:

• Prospective cohort study of 355 patients with stable angina.
• Coronary computed tomography angiography (CTA) performed at baseline.
• Follow-up for major adverse cardiovascular events (all-cause mortality, non-fatal myocardial infarction) over 4.5 years.

Main Results:

• Higher TG/HDL-C ratios were associated with increased prevalence of metabolic syndrome, diabetes, and obstructive CAD at baseline.
• The global CTA risk score and the highest quartile of the TG/HDL-C ratio were independent predictors of the primary composite outcome.
• The TG/HDL-C ratio and CTA risk score demonstrated progression over time, despite lipid-lowering therapies and LDL-C reduction.

Conclusions:

• The TG/HDL-C ratio is a significant independent predictor of adverse CAD outcomes in patients with stable angina.
• Elevated triglycerides and low HDL-C levels contribute to CAD risk beyond LDL-C levels.
• The TG/HDL-C ratio may serve as a valuable biomarker for risk stratification and management in stable angina.