AUTHOR=Wang Le , Cong Hongliang , Zhang Jingxia , Hu Yuecheng , Wei Ao , Zhang Yingyi , Yang Hua , Ren Libin , Qi Wei , Li Wenyu 

TITLE=Predictive Value of the Triglyceride to High-Density Lipoprotein Cholesterol Ratio for All-Cause Mortality and Cardiovascular Death in Diabetic Patients With Coronary Artery Disease Treated With Statins

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.718604

DOI=10.3389/fcvm.2021.718604

ISSN=2297-055X

ABSTRACT=<p><bold>Background and Aims:</bold> Studies have highlighted the role of the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio on subsequent cardiovascular events. However, the association of the TG/HDL-C ratio with survival outcomes in diabetic patients with coronary artery disease (CAD) treated with statins remains unknown. This study aimed to assess the predictive value of the TG/HDL-C ratio for all-cause mortality and cardiovascular death in diabetic patients with CAD treated with statins.</p><p><bold>Methods:</bold> The data of patients with type 2 diabetes and angiographically-confirmed CAD who were undergoing statin therapy and visited Tianjin Chest Hospital between January 2016 and September 2016 were retrospectively collected. The patients were categorized based on the baseline TG/HDL-C ratio tertile. Kaplan-Meier analysis and multivariate Cox proportional hazard regression were applied to assess the role of the TG/HDL-C ratio in predicting all-cause mortality and cardiovascular death.</p><p><bold>Results:</bold> A total of 2,080 patients were included. During the 4-year follow-up, 209 patients died, 136 of whom from cardiovascular death. The Kaplan-Meier analyses showed that an increased TG/HDL-C ratio was associated with an increased risk of all-cause mortality (<italic>P</italic> &lt; 0.001) and cardiovascular death (<italic>P</italic> &lt; 0.001). The multivariate cox hazard regression analysis revealed a similar effect of the TG/HDL-C ratio on the risk of all-cause mortality (<italic>P</italic> = 0.046) and cardiovascular death (<italic>P</italic> = 0.009). The role of the TG/HDL-C ratio in predicting all-cause mortality and cardiovascular death was similar among all subgroups (<italic>P</italic> &gt; 0.050). For all-cause mortality, the TG/HDL-C ratio significantly improved the C-statistic from 0.799 to 0.812 (<italic>P</italic> = 0.018), and the net reclassification index (NRI) and integrated discrimination index (IDI) were 0.252 (95% CI: 0.112–0.392; <italic>P</italic> &lt; 0.001) and 0.012 (95% CI: 0.003–0.022; <italic>P</italic> = 0.012), respectively. Similarly, for cardiovascular death, the TG/HDL-C ratio significantly improved the C-statistic from 0.771 to 0.804 (<italic>P</italic> &lt; 0.001), and the NRI and IDI were 0.508 (95% CI: 0.335–0.680; <italic>P</italic> &lt; 0.001) and 0.033 (95% CI: 0.015–0.050; <italic>P</italic> &lt; 0.001).</p><p><bold>Conclusion:</bold> TG/HDL-C ratio might be useful for predicting all-cause mortality and cardiovascular death in diabetic patients with CAD treated with statins.</p>