Key result
Higher TG/HDL-C ratio linked to ~2.9-fold higher mortality risk per unit increase in COVID-19.
Why the study?
Acute myocardial injury and heart failure are significant prognostic features in COVID-19, and the association of the TG/HDL-C ratio with cardiovascular risk and prognosis in this setting was unclear.
Does an increased TG/HDL-C ratio predict cardiovascular risk and mortality in patients with severe COVID-19?
Observational (n=98)
No
Does an increased TG/HDL-C ratio predict cardiovascular risk and mortality in patients with severe COVID-19?
Odds Ratio: 2.94 (95% CI 1.22–7.12)
p-value: p=0.017
The TG/HDL-C ratio serves as an easily accessible biomarker of insulin resistance that independently predicts cardiovascular complications and mortality in patients with severe COVID-19.
May support TG/HDL-C ratio for COVID-19 prognostication; hypothesis-generating and should not yet change practice.
Background: Acute myocardial injury and heart failure characterized by elevated cardiac troponin and decreased heart pump function are significant clinical features and prognostic factors of coronavirus disease-19 (COVID-19). Triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio is an indicator of insulin resistance. This study aimed to explore the association of the TG/HDL-C ratio with cardiovascular risk and prognosis in COVID-19. Methods: Ninety-eight laboratory-confirmed patients with COVID-19 admitted in a tertiary teaching hospital in Wuhan, China, were enrolled in this retrospective study. Regression models were used to investigate the association between TG/HDL-C ratio with myocardial injury, heart failure, severity, and mortality in COVID-19. Results: Among the 98 patients, the mean age was 63.9± 1.4 years, and male sex (58, 59%) was predominant. Forty-six patients (47%) were admitted to the intensive care unit (ICU), 32 (33%) and 46 (47%) patients suffered from myocardial injury and heart failure, respectively, and 36 (37%) patients died. The TG/HDL-C ratio was increased in patients with myocardial injury, heart failure, severe illness, and fatal outcome ( P < 0.05 for each). Baseline TG/HDL-C ratio significantly correlated with log transformed levels of plasma high-sensitivity cardiac troponin I (r=0.251, P =0.018), N-terminal brain natriuretic propeptide (r=0.274, P =0.008), glycated hemoglobin (r=0.239, P =0.038), and interleukin-6 (r=0.218, P =0.042). Multivariate logistic regression analysis showed that an increased TG/HDL-C ratio was independently associated with the risk of myocardial injury [odds ratio (OR)=2.73; P =0.013], heart failure (OR=2.64; P =0.019), disease severity (OR=3.01; P =0.032), and fatal outcome (OR=2.97; P =0.014). Conclusion: Increased TG/HDL-C ratio was independently associated with myocardial injury, heart failure, disease severity, and mortality in patients with COVID-19, and it may be a useful marker for early identification of patients with high risk and poor outcome.
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Zhang et al. (2020) conducted an observational in COVID-19 (n=98). Triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio vs. Lower TG/HDL-C ratio was evaluated on Mortality (OR 2.94, 95% CI 1.22-7.12, p=0.017). An increased TG/HDL-C ratio was independently associated with a higher risk of mortality (per unit increase OR 2.94), myocardial injury, and disease severity in patients with COVID-19.
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