JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

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Original Article
The relationship between triglyceride/high-density lipoprotein cholesterol ratio and the functional significance of coronary lesions
Abstract
Aims: Have shown that triglycerides (TG) are an independent risk factor for cardiovascular disease (CVD). Dyslipidemia characterized by low high-density lipoprotein cholesterol (HDL-C) has been shown to be associated with symptoms of coronary artery disease (CAD). In studies, the TG/HDL-C ratio has been found to be strongly associated with parameters indicative of the severity of coronary disease. In this study, we aimed to investigate whether the TG/HDL-C ratio is associated with the functional significance of moderate coronary artery lesions.
Methods: A total of 102 consecutive patients, 72 male and 30 female, who underwent measurement of fractional flow reserve (FFR) due to moderate coronary stenosis (quantitative coronary analysis 40-70%) on angiography were included in the study. An FFR value ?0.80 was accepted for hemodynamic significance.
Results: Among the 102 patients included in the study, it was determined that 52 (50.9%) had significant functional stenosis. Left ventricular ejection fraction of Group II was lower than Group I (60 (55-62.5) vs. 55(50-60), p=0.006). The male patient ratio was higher in Group II, but the difference between the two groups was not significant (68% and 77%, respectively, p=0.072). Univariate and multivariate logistic regression analysis showed that TG/HDL-C (OR=1.278, 95% CI=1.078-1.514, p=0.005) was an independent determinant of significant functional stenosis. ROC analysis revealed that the TG/HDL-C value was 3.89 and provided 64% specificity and 61.5% sensitivity in predicting hemodynamically significant coronary artery stenosis.
Conclusion: Elevated TG/HDL-C values are associated with the functional significance of angiographically moderate coronary artery stenosis.

Keywords : Coronary artery disease, triglyceride, fractional flow reserve, HDL-C

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1. Spadaccio C, Glineur D, Barbato E, et al. Fractional Flow reserve-based coronaryartery bypass surgery.<em>JACC Cardiovasc Interv</em>. 2020;13(9):1086-1096.
2. Korkmaz A, Demir M, Unal S, et al. Monocyte-to-high density lipoprotein ratio (MHR) can predict the significance of angiographically intermediate coronary lesions.<em>Int J Cardiovasc Acad</em>. 2017;3(1-2):16-20.
3. Fearon WF, Zimmermann FM, De Bruyne B, et al. Fractional flow reserve-guided PCI as compared with coronary bypass surgery.<em>N Engl J Med</em>. 2022;386(2):128-137.
4. Boutaleb AM, Ghafari C, ungureanu c, carlier s. fractional flow reserve and non-hyperemic indices: essential tools for percutaneous coronary interventions.<em>World J Clin Cases</em>. 2023; 11(10):2123-2139.
5. Harchaoui KE, Visser ME, Kastelein JJ, Stroes ES, Dallinga-Thie GM. Triglycerides and cardiovascular risk.<em>Curr Cardiol Rev</em>. 2009;5(3):216-222.
6. Asakura K, Minami Y, Kinoshita D, et al. Impact of triglyceride levels on plaque characteristics in patients with coronary artery disease.<em>Int J Cardiol.</em>2022;348:134-139.
7. Gianturco SH, Bradley WA, Gotto AM Jr, Morrisett JD, Peavy DL. Hypertriglyceridemic very low density lipoproteins induce triglyceride synthesis and accumulation in mouse peritoneal macrophages.<em>J Clin Invest</em>. 1982;70(1):168-178.
8. McBride P. Triglycerides and risk for coronary artery disease.<em>Curr Atheroscler Rep</em>. 2008;10(5):386-390.
9. Annema W, von Eckardstein A. Dysfunctional high-density lipoproteins in coronary heart disease: implications for diagnostics and therapy.<em>Transl Res</em>. 2016;173:30-57.
10. Guo X, Ma L. Inflammation in coronary artery disease-clinical implications of novel HDL-cholesterol-related inflammatory parameters as predictors.<em>Coron Artery Dis</em>. 2023;34(1):66-77.
11. Li F, Li X, Zhou J, et al. Triglyceride to high-density lipoprotein cholesterol ratio associated with long-term adverse clinical outcomes in patients deferred revascularization following fractional flow reserve.<em>Lipids Health Dis</em>. 2024;23(1):96.
12. Tobis J, Azarbal B, Slavin L. Assessment of intermediate severity coronary lesions in the catheterization laboratory.<em>J Am Coll Cardiol</em>. 2007;49(8):839-848.
13. Pijls NH, Sels JW. Functional measurement of coronary stenosis.<em>J Am Coll Cardiol</em>. 2012;59(12):1045-1057.
14. Nogic J, Prosser H, O&rsquo;Brien J, et al. The assessment of intermediate coronary lesions using intracoronary imaging.<em>Cardiovasc Diagn Ther</em>. 2020;10(5):1445-1460.
15. Koo BK, Hu X, Kang J, et al. Fractional flow reserve or intravascular ultrasonography to guide PCI.<em>N Engl J Med</em>. 2022;387(9):779-789.
16. Tonino PA, De Bruyne B, Pijls NH, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention.<em>N Engl J Med</em>. 2009;360(3):213-224.
17. Lee JM, Kim HK, Park KH, et al. Fractional flow reserve versus angiography-guided strategy in acute myocardial infarction with multivessel disease: a randomized trial.<em>Eur Heart J.</em> 2023;44(6):473-484.
18. Hansson GK. Inflammation, atherosclerosis, and coronary artery disease.<em>N Engl J Med</em>. 2005;352(16):1685-1695.
19. Hilgendorf I, Swirski FK, Robbins CS. Monocyte fate in atherosclerosis.<em>Arterioscler Thromb Vasc Biol</em>. 2015;35(2):272-279.
20. St-Pierre AC, Cantin B, Dagenais GR, et al. Low-density lipoprotein subfractions and the long-term risk of ischemic heart disease in men: 13-year follow-up data from the Qu&eacute;bec Cardiovascular Study.<em>Arterioscler Thromb Vasc Biol</em>. 2005;25(3):553-559.
21. Mikhailidis DP, Elisaf M, Rizzo M, et al. &ldquo;European panel on low density lipoprotein (LDL) subclasses&rdquo;: a statement on the pathophysiology, atherogenicity and clinical significance of LDL subclasses.<em>Curr Vasc Pharmacol</em>. 2011;9(5):533-571.
22. Varbo A, Benn M, Tybj&aelig;rg-Hansen A, J&oslash;rgensen AB, Frikke-Schmidt R, Nordestgaard BG. Remnant cholesterol as a causal risk factor for ischemic heart disease. <em>J Am Coll Cardiol</em>. 2013;61(4):427-436.
23. Hoogeveen RC, Gaubatz JW, Sun W, et al. Small dense low-density lipoprotein-cholesterol concentrations predict risk for coronary heart disease: the Atherosclerosis Risk In Communities (ARIC) study.<em>Arterioscler Thromb Vasc Biol</em>. 2014;34(5):1069-1077.
24. Langsted A, Freiberg JJ, Tybjaerg-Hansen A, Schnohr P, Jensen GB, Nordestgaard BG. Nonfasting cholesterol and triglycerides and association with risk of myocardial infarction and total mortality: the Copenhagen City Heart Study with 31 years of follow-up.<em>J Intern Med</em>. 2011;270(1):65-75.
25. Quispe R, Manalac RJ, Faridi KF, et al. Relationship of the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio to the remainder of the lipid profile: The Very Large Database of Lipids-4 (VLDL-4) study.<em>Atherosclerosis</em>. 2015;242(1):243-250.
26. Triglyceride Coronary Disease Genetics Consortium and Emerging Risk Factors Collaboration, Sarwar N, Sandhu MS, et al. Triglyceride-mediated pathways and coronary disease: collaborative analysis of 101 studies.<em>Lancet</em>. 2010;375(9726):1634-1639.
27. Murphy AJ, Woollard KJ. High-density lipoprotein: a potent inhibitor of inflammation.<em>Clin Exp Pharmacol Physiol</em>. 2010; 37(7):710-718.
28. Murphy AJ, Chin-Dusting JP, Sviridov D, Woollard KJ. The anti inflammatory effects of high density lipoproteins.<em>Curr Med Chem</em>. 2009;16(6):667-675.
29. Hessler JR, Robertson AL Jr, Chisolm III GM. LDL-induced cytotoxicity and its inhibition by HDL in human vascular smooth muscle and endothelial cells in culture.<em>Atherosclerosis</em>. 1979;32(3):213-229.
30. Li XP, Zhao SP, Zhang XY, Liu L, Gao M, Zhou QC. Protective effect of high density lipoprotein on endothelium-dependent vasodilatation.<em>Int J Cardiol</em>. 2000;73(3):231-236.
31. Kuvin JT, R&auml;met ME, Patel AR, Pandian NG, Mendelsohn ME, Karas RH. A novel mechanism for the beneficial vascular effects of high-density lipoprotein cholesterol: enhanced vasorelaxation and increased endothelial nitric oxide synthase expression.<em>Am Heart J</em>. 2002;144(1):165-172.
32. van de Woestijne AP, van der Graaf Y, Liem AH, et al. Low high-density lipoprotein cholesterol is not a risk factor for recurrent vascular events in patients with vascular disease on intensive lipid-lowering medication.<em>J Am Coll Cardiol</em>. 2013;62(20):1834-1841.
33. Che B, Zhong C, Zhang R, et al. Triglyceride-glucose index and triglyceride to high-density lipoprotein cholesterol ratio as potential cardiovascular disease risk factors: an analysis of UK biobank data.<em>Cardiovasc Diabetol</em>. 2023;22(1):34.
34. Dobi&aacute;sov&aacute; M, Frohlich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FER(HDL)).<em>Clin Biochem</em>. 2001;34(7):583-588.
35. Shao QY, Ma XT, Yang ZQ, et al. Prognostic significance of multiple triglycerides-derived metabolic indices in patients with acute coronary syndrome. <em>J Geriatr Cardiol</em>. 2022;19(6):456-468.
36. Su YM, Zhang R, Xu RF, et al. Triglyceride to high-density lipoprotein cholesterol ratio as a risk factor of repeat revascularization among patients with acute coronary syndrome after first-time percutaneous coronary intervention.<em> J Thorac Dis. </em>2019;11(12):5087-5095.
37. Kundi H, Korkmaz A, Balun A, et al. Is in-stent restenosis after a successful coronary stent implantation due to stable angina associated with TG/HDL-C ratio? <em>Angiology</em>. 2017;68(9):816-822.
38. da Luz PL, Favarato D, Faria-Neto JR Jr, Lemos P, Chagas AC. High ratio of triglycerides to HDL-cholesterol predicts extensive coronary disease. <em>Clinics (Sao Paulo)</em>. 2008;63(4):427-432.
39. Bampi AB, Rochitte CE, Favarato D, Lemos PA, da Luz PL. Comparison of non-invasive methods for the detection of coronary atherosclerosis.<em> Clinics (Sao Paulo)</em>. 2009;64(7):675-682.
40. Ates AH, Canpolat U, Yorgun H, et al. Total white blood cell count is associated with the presence, severity and extent of coronary atherosclerosis detected by dual-source multislice computed tomographic coronary angiography. <em>Cardiol J.</em> 2011;18(4):371-377.
Article available in :
Volume 5, Issue 3, 2024
Page : 149-154
https://doi.org/10.47582/jompac.1469728
Article Information
Received : 17 Nis 2024
Accepted : 03 May 2024
Published : 28 Haz 2024
Corresponding Author :

Can Özkan: Department of Cardiology, Bursa City Hospital, Bursa, Turkiye

[email protected]
Citation : Can Özkan. The relationship between triglyceride/high-density lipoprotein cholesterol ratio and the functional significance of coronary lesions. J Med Palliat Care. 2024;5(3):149-154.

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