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. 2016 Oct 27;11(10):e0165484.
doi: 10.1371/journal.pone.0165484. eCollection 2016.

The Predictive Role of Serum Triglyceride to High-Density Lipoprotein Cholesterol Ratio According to Renal Function in Patients with Acute Myocardial Infarction

Jin Sug Kim  1 , Weon Kim  2 , Jong Shin Woo  2 , Tae Won Lee  3 , Chun Gyoo Ihm  3 , Yang Gyoon Kim  3 , Joo Young Moon  3 , Sang Ho Lee  3 , Myung Ho Jeong  4 , Kyung Hwan Jeong  3 ; Korea Acute Myocardial Infarction Registry Investigators
Affiliations

The Predictive Role of Serum Triglyceride to High-Density Lipoprotein Cholesterol Ratio According to Renal Function in Patients with Acute Myocardial Infarction

Jin Sug Kim et al. PLoS One. .

Abstract

Objective: A high serum triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio has been reported as an independent predictor for cardiovascular events in the general population. However, the prognostic value of this ratio in patients with renal dysfunction is unclear. We examined the association of the TG/HDL-C ratio with major adverse cardiovascular events (MACEs) according to renal function in patients with acute myocardial infarction (AMI).

Method: This study was based on the Korea Acute Myocardial Infarction Registry database. Of 13,897 patients who were diagnosed with AMI, the study population included the 7,016 patients with available TG/HDL-C ratio data. Patients were stratified into three groups according to their estimated glomerular filtration rate (eGFR), and the TG/HDL-C ratio was categorized into tertiles. We investigated 12-month MACEs, which included cardiac death, myocardial infarction, and repeated percutaneous coronary intervention or coronary artery bypass grafting.

Results: During the 12-month follow up period, 593 patients experienced MACEs. There was a significant association between the TG/HDL-C ratio and MACEs (p<0.001) in the entire study cohort. Having a TG/HDL-C ratio value in the highest tertile of TG/HDL-C ratio was an independent factor associated with increased risk of MACEs (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.26-1.93; p<0.001). Then we performed subgroup analyses according to renal function. In patients with normal renal function (eGFR ≥ 90 ml/min/1.73m2) and mild renal dysfunction (eGFR ≥ 60 to < 90ml/min/1.73m2), a higher TG/HDL-C ratio was significantly associated with increased risk of MACEs (HR, 1.64; 95% CI, 1.04-2.60; p = 0.035; and HR, 1.56; 95% CI, 1.14-2.12; p = 0.005, respectively). However, in patients with moderate renal dysfunction (eGFR < 60 ml/min/1.73m2), TG/HDL-C ratio lost its predictive value on the risk of MACEs (HR, 1.23; 95% CI, 0.82-1.83; p = 0.317).

Conclusions: In patients with AMI, TG/HDL-C ratio is a useful independent predictor of 12-month MACEs. However, this ratio does not have predictive power in patients with moderate renal dysfunction.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study flow chart.
KAMIR, Korea Acute Myocardial Infarction Registry; AMI, acute myocardial infarction; TG/HDL-C, triglyceride to high-density lipoprotein cholesterol; eGFR, estimated glomerular filtration rate; PCI, percutaneous coronary intervention.
Fig 2
Fig 2. 12-month MACE-free survival according to TG/HDL-C ratio tertile.
MACEs, major adverse cardiovascular events; TG/HDL-C, triglyceride to high-density lipoprotein cholesterol;
Fig 3
Fig 3. 12-month MACE-free survival according to TG/HDL-C ratio in subgroup analyses.
(A) Normal renal function (eGFR ≥ 90 mL/min/1.73m2). (B) Mild renal dysfunction (eGFR ≥ 60 to < 90 mL/min/1.73m2). (C) Moderate renal dysfunction (eGFR < 60 mL/min/1.73m2). MACEs, major adverse cardiovascular events; TG/HDL-C, triglyceride to high-density lipoprotein cholesterol; eGFR, estimated glomerular filtration rate
See this image and copyright information in PMC

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