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. 2019 Dec;11(12):5087-5095.
doi: 10.21037/jtd.2019.12.26.

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

Ya-Min Su  1 , Rui Zhang  1 , Rong-Feng Xu  1 , Hong-Lei Wang  2 , Hai-Hua Geng  3 , Min Pan  3 , Yang-Yang Qu  1 , Wen-Jie Zuo  1 , Zhen-Jun Ji  1 , Gen-Shan Ma  1
Affiliations

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

Ya-Min Su et al. J Thorac Dis. 2019 Dec.

Abstract

Background: It is clinically important to identify high-risk patients with acute coronary syndrome (ACS) who may require repeat revascularization. This retrospective study identified risk factors for repeat revascularization among ACS patients after first-time successful percutaneous coronary interventions (PCIs). The predictive value of the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio for repeat revascularization was also evaluated.

Methods: We enrolled consecutive ACS patients who had coronary angiography performed during the period from 6 to 12 months after a first-time successful PCI. The primary outcome of the study was to identify the risk factors of repeat revascularization. The subjects were stratified based on repeat PCI events. After comparing various clinical characteristics, univariate and multivariate Cox proportional hazard model analyses were adopted to evaluate the effects of risk factors on repeat revascularization.

Results: The patients (n=271) were divided into the event (+) group (n=101) and the event (-) group (n=170). In the event (+) group, target lesion revascularization (TLR) accounted for 20.79% and target vessel revascularization (TVR) accounted for 50.49% of the patients. In contrast, 52.47% of the patients required de novo vessel revascularization (DVR). After adjustment for confounding factors, the TG/HDL-C ratio [hazard ratio (HR) =1.206, 95% confidence interval (CI): 1.016-1.431, P=0.032 for each higher TG/HDL-C ratio unit] and the Gensini score (HR =1.012, 95% CI: 1.005-1.018, P<0.001 for each higher Gensini score unit) were independent risk factors for a repeat PCI. Subgroup analyses showed that higher TG/HDL-C ratios were associated with a significantly higher risk of repeat PCIs in the male, hypertensive, and diabetes mellitus subgroups.

Conclusions: The TG/HDL-C ratio and Gensini score could serve as risk factors for repeat revascularization in ACS patients after a first-time successful PCI.

Keywords: Triglyceride (TG); acute coronary syndrome (ACS); high-density lipoprotein cholesterol (HDL-C); percutaneous coronary intervention (PCI); repeat revascularization.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Composition of the repeat PCI events. TVR, target vessel revascularization; DVR, de novo vessel revascularization; PCI, percutaneous coronary intervention.
Figure 2
Figure 2
HRs of the TG/HDL-C ratio for repeat PCIs in the subgroup analyses. Each subgroup was adjusted for the confounding factors (age, gender, diabetes mellitus, random glucose, TG/HDL-C, Gensini score, and average stent diameter) except for the stratification factor itself. TG/HDL-C, triglyceride to high-density lipoprotein cholesterol ratio; HR, hazard ratio; CI, confidence interval; PCI, percutaneous coronary intervention.
See this image and copyright information in PMC

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