The predictive value of triglyceride to HDL ratio in determining coronary artery disease and plaque morphology

Öz

Aim: As a new atherogenic index, the association of triglyceride to HDL ratio (TG / HDL)with insulin resistance and its significance in risk and prognostic evaluation of cardiovascular diseases have been shown in several studies. TG / HDL ratio may be useful in predicting the presence of coronary artery disease in the population with lowcardiovascular disease risk. In this study, we aimed to evaluate the efficacy of TG / HDL ratio in predicting the presence of CAD and its relationship with plaque morphology, increased coronary calcium score and the degree of stenosisin patients who underwent computed tomographic coronary angiography (CTCA).

Material and Methods: This retrospective cross-sectional study included 161 consecutive patients with low cardiovascular disease risk who were referred to CTCA between 2014-2018.

Results:CAD was detected in 90 patients (55.9%). The TG / HDL ratio was higher in patients with CAD (2.9 (1.7-4.7) vs. 2.6 (1.6-4.1), p = 0.05). In logistic regression analysis, with age, in each one unit increase in TG / HDL ratio was found to associated with 28.7% increase in probabilty of CAD. TG / HDL ratio was not found to be statistically significant in predicting the presence of soft plaques and severe stenosis.

Conclusıon:With advancing age,TG / HDL ratiowas found to be an effective cardiometabolic marker as a more effective parameter than the metabolic syndrome in predicting the presence of CAD. By providing a quantitative assessment with this readily available ratio of dyslipidemia, a more accurate risk assessment can be achieved and thus more individualized treatment can be provided.

Anahtar Kelimeler

• Triglyceride to HDL ratio; Coronary Artery Disease; Coronary Calcium Score; Computed tomographic coronary angiography

Trigliserit/HDL oranının, koroner arter hastalığı varlığını ve plak morfolojisini öngördürmedeki yeri

Öz

Amaç: Yeni bir aterojenik indeks olarak, trigliserid HDL oranının (TG/HDL), insülin rezistansı ile ilişkisi ve kardiyovasküler hastalıklarda risk ve prognostik değerlendirmedeki önemi çeşitli çalışmalarda gösterilmiştir. TG/HDL oranı, düşük kardiyovasküler hastalık riskine sahip populasyonda koroner arter hastalığı varlığını öngördürmede faydalı olabilir. Bu çalışmamızda TG/HDL oranının bilgisayarlı tomografik koroner anjiyografi (BTKA) planlanan hastalarda KAH varlığını öngördürmedeki etkinliği ve bu oranın plak morfolojisi, artmış koroner kalsiyum skoru ve stenoz derecesi ile ilişkisini değerlendirmeyi amaçladık.

Gereç ve Yöntemler: Bu retrospektif kesitsel çalışmaya düşük kardiyovasküler riski olup, 2014-2018 tarihleri arasında BTKA’ya refere edilen ardışık 161 hasta dahil edildi.

Bulgular: 90 hastada (%55.9) KAH saptandı. TG/HDL oranı KAH olan hastalarda yüksekti (2.9 (1.7-4.7)’e karşı 2.6 (1.6-4.1), p=0.05). Lojistik regresyon analizinde, yaş ile birlikte, TG/HDL oranında her bir birim artış,KAH ihtimalinde%28.7 artış ile ilişkili saptandı. Yumuşak plak varlığını ve ciddi darlığı öngördürmede TG/HDL oranı istatistiksel olarak anlamlı bir parametre olarak saptanmadı.

Sonuç: İlerleyen yaşın yanında, TG/HDL oranı KAH varlığını öngördürmede metabolik sendrom varlığından daha etkin bir parametre olarak saptanmış ve etkin bir kardiyometabolik belirteç olduğu gösterilmiştir. Bu kolaylıkla elde edilebilen dislipidemi oranı ile niceliksel değerlendirme sağlanarak daha doğru risk değerlendirilmesi ve böylelikle daha bireyselleştirilmiş tedavi sağlanabilir.

Anahtar Kelimeler

• Trigliserid HDL oranı; Koroner Arter Hastalığı; Koroner Kalsiyum Skoru; Bilgisayarlı Tomografik Koroner Anjiyografi

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