Triglycerides/High-Density Lipoprotein Ratio and Coronary Artery Disease: Results from a Large Single-Center Study

Background. Despite the achievement of therapeutic goals regarding low-density lipoprotein cholesterol (LDL-C) levels with statins, high residual risk of events was reported in patients with coronary artery disease (CAD). Widespread attention has recently been focused on low plasmatic levels of high-density lipoproteins (HDLs) and high levels of triglycerides as risk factors for cardiovascular disease and as potential pharmacological targets, with particular attention paid to their ratio. Therefore, the aim of the current study was to investigate the association between triglycerides and HDLs and the TG/HDL ratio and their association with the prevalence and extent of CAD. Methods. We included patients undergoing non-urgent coronary angiography at Azienda Ospedaliera-Universitaria "Maggiore della Carità", Novara, Italy, from 2007 to 2018. Patients chronically treated with triglyceride-lowering therapies (PUFA and Fibrates) were excluded from this analysis. Fasting samples were collected at the moment of angiography. CAD was defined as at least one vessel stenosis >50%. Results. Our study population of 5997 patients was divided according to TG/HDL ratio quartiles. The TG/HDL ratio was significantly associated with age, gender, smoking status, hypercholesterolemia, diabetes, and the chronic use of ACE inhibitors, statins, beta-blockers, aspirin, ADP antagonists, and diuretics. The TG/HDL ratio was additionally associated with several laboratory parameters. In multiple logistic regression analysis, HDLs but not the TG/HDL ratio were independently associated with the prevalence and extent of CAD. Conclusions. Our study showed that HDLs but not the TG/HDL ratio are independently associated with the extent and prevalence of CAD. Therefore, this ratio does not provide additional prognostic information to HDLs in the prediction of the prevalence and extent of this disease.