Key result
High TG/HDL-C ratio linked to ~10-fold higher rate of severe CAD in STEMI patients.
Why the study?
The TG/HDL-C ratio may reflect an atherogenic lipid profile associated with greater coronary disease burden, prompting evaluation of its relationship with angiographic CAD severity using vessel and Gensini scores among patients with STEMI.
Does a high TG/HDL-C ratio (≥4) compared to a low TG/HDL-C ratio (<4) correlate with greater angiographic severity and extent of coronary artery disease (measured by Gensini and vessel scores) in patients presenting with STEMI?
Cross-Sectional (n=73)
Single-blind
No
Does a high TG/HDL-C ratio (≥4) compared to a low TG/HDL-C ratio (<4) correlate with greater angiographic severity and extent of coronary artery disease (measured by Gensini and vessel scores) in patients presenting with STEMI?
In Bangladeshi patients presenting with STEMI, a fasting TG/HDL-C ratio ≥4 is strongly associated with a higher burden of multi-vessel and angiographically severe coronary artery disease (Gensini score >20), supporting its utility as a simple marker of severe coronary involvement.
Answers are grounded in this paper and cite their sources.
High TG/HDL-C ratio was associated with severe CAD in STEMI; hypothesis-generating for risk stratification, prospective validation required.
Background: ST-elevation myocardial infarction (STEMI) is a major manifestation of coronary artery disease (CAD), and the extent of coronary involvement is an important indicator of disease severity. The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio may reflect an atherogenic lipid profile associated with greater coronary disease burden. Objective: To assess the angiographic severity of CAD using vessel and Gensini scores and determine its relationship with the TG/HDL-C ratio among patients with STEMI. Method: This cross-sectional observational study was conducted among 73 patients with STEMI at the Department of Cardiology, Sylhet MAG Osmani Medical College Hospital, Bangladesh, from July 2019 to June 2021. Patients were categorized into high (≥4) and low (<4) TG/HDL-C groups. Coronary angiography was performed during hospitalization, and CAD severity was assessed using vessel and Gensini scores. Severe CAD was defined as a Gensini score >20. Data were analyzed using SPSS version 25.0. Results: The mean age was 51.03±10.47 years, and 84.9% were male. Chest pain was the predominant presenting symptom (98.6%). Hypertension was significantly more common in the high TG/HDL-C group than in the low-ratio group (66.0% vs. 34.8%, p=0.013). Mean Gensini score was significantly higher among patients with TG/HDL-C ≥4 than among those with <4 (39.4±24.29 vs. 11.34±7.37, p=0.0001). Severe CAD was present in 86.0% of patients with TG/HDL-C ≥4 compared with 8.7% of those with <4 (p=0.0001). Vessel involvement also differed significantly between groups (p=0.022). Conclusion: A higher TG/HDL-C ratio was strongly associated with greater angiographic severity and extent of CAD among patients with STEMI. The TG/HDL-C ratio may serve as a simple, readily available marker of severe coronary involvement.
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Akbar et al. (2026) conducted a cross-sectional in ST-elevation myocardial infarction (STEMI) (n=73). High TG/HDL-C ratio (>=4) vs. Low TG/HDL-C ratio (<4) was evaluated on Severe coronary artery disease (Gensini score >20) (p=0.0001). A high TG/HDL-C ratio (>=4) was associated with a higher rate of severe CAD (86.0% vs 8.7%, p=0.0001) and mean Gensini score (39.4 vs 11.34, p=0.0001) than a ratio <4 in STEMI patients.
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