High ratio of triglycerides to HDL-cholesterol predicts extensive coronary disease

An abnormal ratio of triglycerides to HDL-cholesterol (TG/HDL-c) indicates an atherogenic lipid profile and a risk for the development of coronary disease. OBJECTIVE: To investigate the association between lipid levels, specifically TG/HDL-c, and the extent of coronary disease. METHODS: High-risk patients (n = 374) submitted for coronary angiography had their lipid variables measured and coronary disease extent scored by the Friesinger index. RESULTS: The subjects consisted of 220 males and 154 females, age 57.2 +/- 11.1 years, with total cholesterol of 210 +/- 50.3 mg/ dL, triglycerides of 173.8 +/- 169.8 mg/dL, HDL-cholesterol (HDL-c) of 40.1 +/- 12.8 m(mg/dL, LDL-cholesterol (LDL-c) of 137.3 +/- 46.2 mg/dL, TG/HDL-c of 5.1 +/- 5.3, and a Friesinger index of 6.6 +/- 4.7. The relationship between the extent of coronary disease (dichotomized by a Friesenger index of 5 and lipid levels (normal vs. abnormal) was statistically significant for the following: triglycerides, odds ratio of 2.02 (1.31-3. 1; p = 0.0018); HDL-c, odds ratio of 2.21 (1.42-3.43; p = 0.0005); and TG/HDL-c, odds ratio of 2.01(1.30-3.09; p = 0.0018). However, the relationship was not significant between extent of coronary disease and total cholesterol 11.25 (0.82-1.91; p = 0.33)] or LDL-c 11.47 (0.96-2.25; p = 0.0842)]. The chi-square for linear trends for Friesinger > 4 and lipid quartiles was statistically significant for triglycerides (p = 0.00 17). HDL-c (p = 0.000 1), and TGIHDL-c (p = 0.00 18), but not for total cholesterol (p = 0.393) or LDL-c (p = 0.0568). The multivariate analysis by logistic regression OR gave 1.3 +/- 0.79 (p =.0001) for TG/HDL-c, 0.779 +/- 0.074 (p =.0001) for HDL-c, and 1.234 +/- 0.097 (p = 0.03) for LDL. Analysis of' receiver operating characteristic curves showed that only TG/HDL-c and HDL-c were useful for detecting extensive coronary disease, with the former more strongly associated with disease. CONCLUSIONS: Although some lipid variables were associated with the extent of coronary disease, the ratio of' triglycerides to HDL-cholesterol showed the strongest association with extent.