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Prognostic value of non-traditional lipid parameters: Castelli Risk Index I, Castelli Risk Index II, and
Dominika Drwiła1, Paweł Rostoff2, Jadwiga Nessler2
1Department of Coronary Disease and Heart Failure, John Paul II Hospital.
Insights
The Castelli Risk Index I, Castelli Risk Index II, and triglycerides to HDL-C ratio do not predict major adverse cardiovascular events or mortality in NSTEMI patients. These lipid indices also do not correlate with coronary artery disease severity.
Area of Science:
- Cardiology
- Lipid Metabolism
- Clinical Risk Assessment
Background:
- Classical lipoprotein concentrations are established in non-invasive cardiology.
- The clinical utility of Castelli Risk Index I (CRI I), Castelli Risk Index II (CRI II), and the triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio is under evaluation.
- Non-ST-segment elevation myocardial infarction (NSTEMI) is a critical cardiovascular condition requiring accurate prognostic markers.
Purpose of the Study:
- To assess the predictive value of CRI I, CRI II, and TG/HDL-C for Major Adverse Cardiovascular Events (MACE).
- To evaluate the predictive value of CRI I, CRI II, and TG/HDL-C for all-cause mortality.
- To determine the correlation between these lipid indices and coronary artery disease (CAD) severity in NSTEMI patients.
Main Methods:
- A cohort of 1,301 NSTEMI patients was analyzed.
- Statistical associations were examined between CRI I, CRI II, TG/HDL-C, and the occurrence of MACE and 1-year mortality.
- Correlations between lipid indices and CAD severity were assessed using regression analysis.
Main Results:
- MACE occurred in 10.9% of patients, and 1-year mortality was 13.4%.
- None of the evaluated lipid indices (CRI I, CRI II, TG/HDL-C) independently predicted MACE or 1-year mortality in the overall NSTEMI population or in subgroups (e.g., with diabetes or prior CAD).
- Only a weak correlation was found between CAD severity and CRI I (R=0.08, p=0.02); no significant correlations were observed for CRI II or TG/HDL-C.
Conclusions:
- CRI I, CRI II, and the TG/HDL-C ratio are not recommended as predictors for MACE or all-cause mortality in NSTEMI patients.
- These lipid-based risk indices do not effectively reflect the severity of coronary artery disease in this patient group.
- Further research may be needed to identify more reliable prognostic markers for NSTEMI outcomes.
Abstract:
Aim Concentrations of classical lipoproteines have a well-established role in non-invasive cardiology. The efficacy of the Castelli Risk Index I (CRI I), Castelli Risk Index II (CRI II), and triglycerides to high-density lipoprotein cholesterol (TG / HDL-C) ratio in clinical practice are currently under evaluation. The study aimed to assess the predictive value of CRI I, CRI II and TG / HDL-C for the incidence of Major Adverse Cardiovascular Events (MACE) and for all-cause mortality during 1‑year follow-up of patients with non-ST-segment elevation myocardial infarction (NSTEMI).Material and Methods 1,301 patients were enrolled in the study. Associations between CRI I, CRI II, TG / HDL-C and occurrence of MACE and 1‑year mortality were studied. Moreover correlations between CRI I, CRI II, and TG / HDL-C and the severity of coronary artery disease (CAD) were assessed.Results MACE occurred in 10.9 % (142) of patients, and 1‑year mortality was 13.4 % (174). None of the evaluated indices appeared to be an independent predictor of MACE in either the entire population or subpopulations, as divided according to the presence of diabetes or CAD diagnosed prior to admission. Furthermore, no dependence between 1‑year mortality and the examined indices was found. Additionally, only a weak correlation between CAD severity and CRI I was observed (R=0.08, p=0.02). No significant correlations for CRI II (p=0.07) and TG / HDL-C (p=0.6) were detected.Conclusions CRI I, CRI II and TG / HDL-C should not be used as predictors of MACE or all-cause mortality among patients with NSTEMI. Moreover, these indices do not reflect CAD severity.
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