High Ratio of Triglycerides to HDL-Cholesterol Predicts Extensive Coronary Disease

UNLABELLED: An abnormal ratio of triglycerides to HDL-cholesterol (TG/HDL-c) indicates an atherogenic lipid profile and a risk for the development of coronary disease. OBJECTIVE: To investigate the association between lipid levels, specifically TG/HDL-c, and the extent of coronary disease. METHODS: High-risk patients (n=374) submitted for coronary angiography had their lipid variables measured and coronary disease extent scored by the Friesinger index. RESULTS: The subjects consisted of 220 males and 154 females, age 57.2+/-11.1 years, with total cholesterol of 210+/-50.3 mg/dL, triglycerides of 173.8+/-169.8 mg/dL, HDL-cholesterol (HDL-c) of 40.1+/-12.8 mg/dL, LDL-cholesterol (LDL-c) of 137.3+/-46.2 mg/dL, TG/HDL-c of 5.1+/-5.3, and a Friesinger index of 6.6+/-4.7. The relationship between the extent of coronary disease (dichotomized by a Friesenger index of 5 and lipid levels (normal vs. abnormal) was statistically significant for the following: triglycerides, odds ratio of 2.02 (1.31-3.1; p=0.0018); HDL-c, odds ratio of 2.21 (1.42-3.43; p=0.0005); and TG/HDL-c, odds ratio of 2.01(1.30-3.09; p=0.0018). However, the relationship was not significant between extent of coronary disease and total cholesterol 1.25 (0.82-1.91; p=0.33) or LDL-c 1.47 (0.96-2.25; p=0.0842). The chi-square for linear trends for Friesinger >4 and lipid quartiles was statistically significant for triglycerides (p=0.0017), HDL-c (p=0.0001), and TG/HDL-c (p=0.0018), but not for total cholesterol (p=0.393) or LDL-c (p=0.0568). The multivariate analysis by logistic regression OR gave 1.3+/-0.79 (p= .0001) for TG/HDL-c, 0.779+/-0.074 (p= .0001) for HDL-c, and 1.234+/-0.097 (p=0.03) for LDL. Analysis of receiver operating characteristic curves showed that only TG/HDL-c and HDL-c were useful for detecting extensive coronary disease, with the former more strongly associated with disease. CONCLUSIONS: Although some lipid variables were associated with the extent of coronary disease, the ratio of triglycerides to HDL-cholesterol showed the strongest association with extent.