Key result
A higher TG/HDLc ratio was strongly associated with severe coronary lesions (OR 3.46; 95% CI 1.32-9.10), outperforming TG or HDLc alone in assessing coronary artery disease severity.
Why the study?
CAD involves dyslipidemia and chronic inflammation, and cardiovascular disease mortality is rising in India, motivating exploration of NLR and TG/HDLc ratio to assess angiographic coronary lesion extent.
Observational (n=126)
No
The TG/HDLc ratio and NLR are inexpensive, easily accessible markers that significantly correlate with the angiographic severity of coronary artery disease.
May support TG/HDLc for CAD severity grading; leaves open incremental value in prospective cohorts.
Context: Coronary artery disease (CAD) occurs as a consequence of dyslipidemia and chronic inflammation. Cardiovascular disease mortality is on the rise in India. Aims: Explore the utility of simple markers such as neutrophil-to-lymphocyte ratio (NLR) and triglyceride/high-density lipoprotein cholesterol (TG/HDLc) ratio, to study the extent of coronary lesions as seen on angiography. Settings and Design: Observational study in a tertiary-care hospital in North-India. Methodology: Coronary angiograms of 126 outpatients were graded as per Friesinger Index. Lipid profile was analyzed for each patient, along with complete blood count parameters, including total leukocyte count (TLC), absolute neutrophil, and lymphocyte counts and mean platelet volume (MPV). Statistical Analysis Used:Comparison of groups was done using a Mann–Whitney U test, of continuous variables using a correlation coefficient, and of categorical variables using a Chi-square test, and odds ratios were estimated. Receiver operator characteristic curves were constructed, and cutoffs were obtained. Results: TG/HDLc-ratio was associated with severe coronary lesions (Friesinger-Index ≥5) [odds ratio (OR): 3.46; 95% confidence interval (CI): 1.32–9.10], which was stronger than the association of TG [OR: 3.15; 95%CI: 1.33–7.42] or HDLc [OR: 1.86; 95%CI: 0.81–3.82] alone. No association existed for total or low-density lipoprotein cholesterol. NLR was significantly higher among patients with severe lesions. NLR and MPV were significantly correlated with TG/HDLc ratio. Area under curve for TG/HDLc ratio and NLR was 73.7 and 60.8. Cutoff values were 2.53 (Sensitivity (SN) = 83.1%, Specificity (SP) = 56.7%) and 1.84 (SN = 61.0%, SP = 49.3%), respectively. Conclusions: TG/HDLc ratio and NLR are associated with CAD severity, more so than TG or HDLc alone, or TLC. They are easily accessible and inexpensive markers that may be utilized in identifying patients at risk for heart disease.
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Dudani et al. (2020) conducted an observational in Coronary artery disease (n=126). Triglyceride/high-density lipoprotein cholesterol (TG/HDLc) ratio and neutrophil-to-lymphocyte ratio (NLR) vs. Triglycerides, HDLc alone, or total leukocyte count was evaluated on Severe coronary lesions (Friesinger-Index ≥5) (OR 3.46, 95% CI 1.32-9.10). A higher TG/HDLc ratio was strongly associated with severe coronary lesions (OR 3.46; 95% CI 1.32-9.10), outperforming TG or HDLc alone in assessing coronary artery disease severity.
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