Impact of low high-density lipoprotein-cholesterol level on 2-year clinical outcomes after acute myocardial infarction in patients with diabetes mellitus

Joo, Hyung Joon; Cho, Sang A.; Hong, Soon Jun; Hur, Seung Ho; Bae, Jang Ho; Choi, Dong Ju; Ahn, Young Keun; Park, Jong Seon; Choi, Rak Kyeong; Choi, Donghoon; Kim, Joon Hong; Han, Kyoo Rok; Park, Hun Sik; Choi, So Yeon; Yoon, Jung Han; Kwon, Hyeon Jeong; Rha, Seung Woon; Hwang, Kyung Kuk; Jung, Kyung Tae; Oh, Seok Kyu; Lee, Jae‐Hwan; Shin, Eun Seok; Kim, Kee Sik; Kim, Hyo Soo; Lim, Do Sun

doi:10.1186/s12944-016-0374-5

Cited by 5 publications

(3 citation statements)

References 43 publications

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“…Dyslipidemia is characterized by elevated triglyceride (TG) and reduced dense high-density lipoprotein cholesterol particles levels, and lower high-density lipoprotein cholesterol (HDL-C) levels in diabetic patients (7,8). Elevated TG and lower HDL-C are associated with poor prognosis in diabetic patients (9)(10)(11)(12), but the use TG or HDL-C alone does not reflect the risk of atherosclerosis and cardiovascular disease (CVD) (13). The TG/HDL-C ratio may reflect the actual lipid profiles, and is considered an important marker of plasma atherosclerosis (14).…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of the Triglyceride to High-Density Lipoprotein Cholesterol Ratio for All-Cause Mortality and Cardiovascular Death in Diabetic Patients With Coronary Artery Disease Treated With Statins

Wang

Cong

Zhang

et al. 2021

Front. Cardiovasc. Med.

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Background and Aims: Studies have highlighted the role of the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio on subsequent cardiovascular events. However, the association of the TG/HDL-C ratio with survival outcomes in diabetic patients with coronary artery disease (CAD) treated with statins remains unknown. This study aimed to assess the predictive value of the TG/HDL-C ratio for all-cause mortality and cardiovascular death in diabetic patients with CAD treated with statins.Methods: The data of patients with type 2 diabetes and angiographically-confirmed CAD who were undergoing statin therapy and visited Tianjin Chest Hospital between January 2016 and September 2016 were retrospectively collected. The patients were categorized based on the baseline TG/HDL-C ratio tertile. Kaplan-Meier analysis and multivariate Cox proportional hazard regression were applied to assess the role of the TG/HDL-C ratio in predicting all-cause mortality and cardiovascular death.Results: A total of 2,080 patients were included. During the 4-year follow-up, 209 patients died, 136 of whom from cardiovascular death. The Kaplan-Meier analyses showed that an increased TG/HDL-C ratio was associated with an increased risk of all-cause mortality (P < 0.001) and cardiovascular death (P < 0.001). The multivariate cox hazard regression analysis revealed a similar effect of the TG/HDL-C ratio on the risk of all-cause mortality (P = 0.046) and cardiovascular death (P = 0.009). The role of the TG/HDL-C ratio in predicting all-cause mortality and cardiovascular death was similar among all subgroups (P > 0.050). For all-cause mortality, the TG/HDL-C ratio significantly improved the C-statistic from 0.799 to 0.812 (P = 0.018), and the net reclassification index (NRI) and integrated discrimination index (IDI) were 0.252 (95% CI: 0.112–0.392; P < 0.001) and 0.012 (95% CI: 0.003–0.022; P = 0.012), respectively. Similarly, for cardiovascular death, the TG/HDL-C ratio significantly improved the C-statistic from 0.771 to 0.804 (P < 0.001), and the NRI and IDI were 0.508 (95% CI: 0.335–0.680; P < 0.001) and 0.033 (95% CI: 0.015–0.050; P < 0.001).Conclusion: TG/HDL-C ratio might be useful for predicting all-cause mortality and cardiovascular death in diabetic patients with CAD treated with statins.

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Section: Introductionmentioning

confidence: 99%

Predictive Value of the Triglyceride to High-Density Lipoprotein Cholesterol Ratio for All-Cause Mortality and Cardiovascular Death in Diabetic Patients With Coronary Artery Disease Treated With Statins

Wang

Cong

Zhang

et al. 2021

Front. Cardiovasc. Med.

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“…In an observational study conducted in Korea, cardiovascular events were shown to have a high prevalence in DM populations with a low HDL-C concentration. 33 In a retrospective cohort study conducted by Squillace et al, 34 a high TG/HDL ratio was found to predict the risk of new-onset DM independent of other traditional risk factors. Taken together, these findings suggest that levels of HDL-C and TGs may represent important early markers of DN and DM.…”

Section: Discussionmentioning

confidence: 96%

Tumour necrosis factor-related apoptosis-inducing ligand expression in patients with diabetic nephropathy

Chang

Liang²,

Yao

et al. 2018

J Renin Angiotensin Aldosterone Syst

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Objective:The objective of this study was to evaluate the expression profile of tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) in patients with diabetic nephropathy (DN).Methods:A total of 126 Chinese subjects were enrolled in this study, including 42 patients with diabetes mellitus (DM), 42 patients with DN and 42 healthy controls. Real-time polymerase chain reaction was performed to analyze levels of TRAIL mRNA in peripheral blood mononuclear cells (PBMCs). Serum levels of soluble TRAIL (sTRAIL) and various cytokines were detected with a commercially available enzyme-linked immunosorbent assay kit.Results:Compared with the control group, the levels of TRAIL mRNA in PBMCs and sTRAIL in sera were both significantly decreased in the DM and DN patients (P < 0.05). Conversely, levels of interleukin (IL)-1, IL-6, tumour necrosis factor-α and monocyte chemotactic protein-1 were higher in the DN group than in the control group. Serum levels of TRAIL positively correlated with TRAIL mRNA levels in all of the subjects examined (P < 0.05).Conclusions:These results provide support and a theoretical basis for further research of TRAIL in regard to the pathogenesis of DN.

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“…Dyslipidemia is characterized by higher triglyceride (TG) levels, lower high-density lipoprotein cholesterol (HDL-C) levels and increased small dense high-density lipoprotein cholesterol(sd-LDL) particles in patients with T2DM [7,8]. It has been demonstrated that elevated serum TG and reduced HDL-C levels contribute to poor prognosis in patients with T2DM [9][10][11][12]. However, TG and HDL-C levels alone do not re ect the actual status of plasma atherogenicity and cardiovascular disease (CVD) risk [13].…”

Section: Introductionmentioning

confidence: 99%

Triglyceride to high-density lipoprotein cholesterol ratio predicts all-cause and cardiovascular mortality in diabetic patients with coronary artery disease on statin treatment

Wang

Cong

Zhang

et al. 2021

Preprint

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Background The triglyceride (TG)to high-density lipoprotein cholesterol (HDL-C) ratio has been regarded as an independent predictor of cardiovascular events. However, the association of TG/HDL-C ratio with survival in patients with diabetes and coronary artery disease (CAD) on statin therapy remains uncertain. The aim of the present study was to explore whether TG/HDL-C ratio predicts mortality in diabetic patients with CAD on statin treatment. Methods A total of 2080 consecutive patients with type 2 diabetes and angiographic-proven CAD who were treated with statin were enrolled in the presents study. Patients were divided into tertiles according to baseline TG/HDL-C ratio. The primary endpoints were all-cause and cardiovascular mortality. Results During 4-year follow-up, 209(10.0%) patients died, 136(65.1%) caused by cardiovascular disease (CVD). The Kaplan-Meier analyses showed that all-cause and cardiovascular mortality increased gradually with rising TG/HDL-C ratio tertiles (log-rank test, P < 0.001, respectively). Multivariate cox hazard regression analysis revealed that patients in tertile 3 but not teretile 2 had significantly higher rate of all-cause and cardiovascular mortality (P < 0.001, P < 0.05, respectively). Moreover, TG/HDL-C ratio was independently associated with all-cause mortality (HR: 1.21, 95% CI:1.11–1.31; P < 0.001) and cardiovascular mortality (HR:1.28, 95% CI: 1.19–1.37; P < 0.001). For all-cause mortality, TG/HDL-C ratio significantly improved the C-statistic (0.799[0.766–0.833] to 0.813[0.780–0.845]; P = 0.018), net reclassification index (NRI) (0.315; P < 0.001), and integrated discrimination index (IDI) (0.012; P = 0.003). For cardiovascular mortality, TG/HDL-C ratio significantly improved the C-statistic (0.769[0.727–0.812] to 0.810[0.771–0.849]; P = 0.001), NRI (0.442; P < 0.001), and IDI (0.039; P < 0.001). Conclusions TG/HDL-C ratio may predict mortality risk among diabetic CAD patients receiving statin treatment. These findings suggest that assessing TG/HDL-C ratio may be useful for risk stratification for mortality risk in patients with diabetes and CAD.

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Impact of low high-density lipoprotein-cholesterol level on 2-year clinical outcomes after acute myocardial infarction in patients with diabetes mellitus

Cited by 5 publications

References 43 publications

Predictive Value of the Triglyceride to High-Density Lipoprotein Cholesterol Ratio for All-Cause Mortality and Cardiovascular Death in Diabetic Patients With Coronary Artery Disease Treated With Statins

Predictive Value of the Triglyceride to High-Density Lipoprotein Cholesterol Ratio for All-Cause Mortality and Cardiovascular Death in Diabetic Patients With Coronary Artery Disease Treated With Statins

Tumour necrosis factor-related apoptosis-inducing ligand expression in patients with diabetic nephropathy

Triglyceride to high-density lipoprotein cholesterol ratio predicts all-cause and cardiovascular mortality in diabetic patients with coronary artery disease on statin treatment

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