title: Usefulness of triglycerides-to-high-density lipoprotein cholesterol ratio for predicting the first coronary event in men.
abstract: Overweight and obesity potentiate the development of cardiovascular risk factors but many doubts have arisen recently regarding their role in coronary events. We evaluated the predictive value of a surrogate maker of insulin resistance, the ratio of triglyceride (TG) to high-density lipoprotein (HDL), for the incidence of a first coronary event in men workers according to body mass index (BMI). We designed a case-control study of active subjects collected from a single factory through their annual health examination and medical reports. Case subjects included those with myocardial infarction, unstable angina pectoris, or subclinical myocardial ischemia detected through electrocardiographic abnormalities. The sample was constituted by 208 case and 2,080 control subjects (mean age 49.9 years, 49.6 to 50.2). General characteristics of case and control subjects were well matched. The TG/HDL ratio was significantly higher in case subjects compared to controls. Stratification of the sample revealed an increasing prevalence of case subjects and mean TG/HDL in each category of BMI. Multivariable analysis, adjusted by smoking, demonstrated that TG/HDL increased 50% the risk of a first coronary event (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.26 to 1.71), whereas low-density lipoprotein cholesterol values indicated a more moderate increased risk (OR 1.01, 95% CI 1.005 to 1.012); metabolic syndrome (OR 1.76, 95% CI 0.94 to 3.30) and hypertension (OR 1.50, 95% CI 0.81 to 2.79) did not reach statistical significance. The TG/HDL ratio was associated with a first coronary event in all categories of BMI. In conclusion, the TG/HDL ratio has a high predictive value of a first coronary event regardless of BMI.
authors.affiliation: Department of Cardiology, Hospital Universitario de San Juan, Alicante, Spain. acordero@coma.es
authors.forename: Alberto
authors.initials: A
authors.lastname: Cordero
authors.forename: Eva
authors.initials: E
authors.lastname: Andrés
authors.forename: Beatriz
authors.initials: B
authors.lastname: Ordoñez
authors.forename: Montserrat
authors.initials: M
authors.lastname: León
authors.forename: Martín
authors.initials: M
authors.lastname: Laclaustra
authors.forename: Alberto
authors.initials: A
authors.lastname: Grima
authors.forename: Emilio
authors.initials: E
authors.lastname: Luengo
authors.forename: José
authors.initials: J
authors.lastname: Moreno
authors.forename: María
authors.initials: M
authors.lastname: Bes
authors.forename: Isaac
authors.initials: I
authors.lastname: Pascual
authors.forename: Fernando
authors.initials: F
authors.lastname: Civeira
authors.forename: Miguel
authors.initials: M
authors.lastname: Pocoví
authors.forename: Eduardo
authors.initials: E
authors.lastname: Alegría
authors.forename: José A
authors.initials: JA
authors.lastname: Casasnovas
mesh_terms: D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000097:blood* / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D004562:Electrocardiography; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008075:Lipoproteins, HDL / Q000097:blood*; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000097:blood* / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D011237:Predictive Value of Tests; D018570:Risk Assessment / Q000379:methods*; D014280:Triglycerides / Q000097:blood*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D014280:Triglycerides