Why the study?
The clinical efficacy of non-traditional lipid parameters, including Castelli Risk Index I, Castelli Risk Index II, and TG/HDL-C ratio, was under evaluation in clinical practice.
Do non-traditional lipid parameters (CRI I, CRI II, and TG/HDL-C ratio) predict MACE and all-cause mortality in patients with NSTEMI?
Do non-traditional lipid parameters (CRI I, CRI II, and TG/HDL-C ratio) predict MACE and all-cause mortality in patients with NSTEMI?
Non-traditional lipid parameters including CRI I, CRI II, and TG/HDL-C ratio do not independently predict 1-year MACE or all-cause mortality in patients with NSTEMI.
CRI I, CRI II, and TG/HDL-C may aid 1-year MACE and mortality prediction; leaves open routine adoption pending validation.
Aim Concentrations of classical lipoproteines have a well-established role in non-invasive cardiology. The efficacy of the Castelli Risk Index I (CRI I), Castelli Risk Index II (CRI II), and triglycerides to high-density lipoprotein cholesterol (TG / HDL-C) ratio in clinical practice are currently under evaluation. The study aimed to assess the predictive value of CRI I, CRI II and TG / HDL-C for the incidence of Major Adverse Cardiovascular Events (MACE) and for all-cause mortality during 1‑year follow-up of patients with non-ST-segment elevation myocardial infarction (NSTEMI).Material and Methods 1,301 patients were enrolled in the study. Associations between CRI I, CRI II, TG / HDL-C and occurrence of MACE and 1‑year mortality were studied. Moreover correlations between CRI I, CRI II, and TG / HDL-C and the severity of coronary artery disease (CAD) were assessed.Results MACE occurred in 10.9 % (142) of patients, and 1‑year mortality was 13.4 % (174). None of the evaluated indices appeared to be an independent predictor of MACE in either the entire population or subpopulations, as divided according to the presence of diabetes or CAD diagnosed prior to admission. Furthermore, no dependence between 1‑year mortality and the examined indices was found. Additionally, only a weak correlation between CAD severity and CRI I was observed (R=0.08, p=0.02). No significant correlations for CRI II (p=0.07) and TG / HDL-C (p=0.6) were detected.Conclusions CRI I, CRI II and TG / HDL-C should not be used as predictors of MACE or all-cause mortality among patients with NSTEMI. Moreover, these indices do not reflect CAD severity.
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Drwiła et al. (2022) studied this question.
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