title: The Predictive Role of Serum Triglyceride to High-Density Lipoprotein Cholesterol Ratio According to Renal Function in Patients with Acute Myocardial Infarction.
abstract: OBJECTIVE
  A high serum triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio has been reported as an independent predictor for cardiovascular events in the general population. However, the prognostic value of this ratio in patients with renal dysfunction is unclear. We examined the association of the TG/HDL-C ratio with major adverse cardiovascular events (MACEs) according to renal function in patients with acute myocardial infarction (AMI).
  
  
  METHODS
  This study was based on the Korea Acute Myocardial Infarction Registry database. Of 13,897 patients who were diagnosed with AMI, the study population included the 7,016 patients with available TG/HDL-C ratio data. Patients were stratified into three groups according to their estimated glomerular filtration rate (eGFR), and the TG/HDL-C ratio was categorized into tertiles. We investigated 12-month MACEs, which included cardiac death, myocardial infarction, and repeated percutaneous coronary intervention or coronary artery bypass grafting.
  
  
  RESULTS
  During the 12-month follow up period, 593 patients experienced MACEs. There was a significant association between the TG/HDL-C ratio and MACEs (p<0.001) in the entire study cohort. Having a TG/HDL-C ratio value in the highest tertile of TG/HDL-C ratio was an independent factor associated with increased risk of MACEs (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.26-1.93; p<0.001). Then we performed subgroup analyses according to renal function. In patients with normal renal function (eGFR ≥ 90 ml/min/1.73m2) and mild renal dysfunction (eGFR ≥ 60 to < 90ml/min/1.73m2), a higher TG/HDL-C ratio was significantly associated with increased risk of MACEs (HR, 1.64; 95% CI, 1.04-2.60; p = 0.035; and HR, 1.56; 95% CI, 1.14-2.12; p = 0.005, respectively). However, in patients with moderate renal dysfunction (eGFR < 60 ml/min/1.73m2), TG/HDL-C ratio lost its predictive value on the risk of MACEs (HR, 1.23; 95% CI, 0.82-1.83; p = 0.317).
  
  
  CONCLUSIONS
  In patients with AMI, TG/HDL-C ratio is a useful independent predictor of 12-month MACEs. However, this ratio does not have predictive power in patients with moderate renal dysfunction.
authors: Department of Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
authors: Jin Sug
authors: JS
authors: Kim
authors: Division of Cardiology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: Weon
authors: W
authors: Kim
authors: Division of Cardiology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: Jong Shin
authors: JS
authors: Woo
authors: Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: Tae Won
authors: TW
authors: Lee
authors: Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: Chun Gyoo
authors: CG
authors: Ihm
authors: Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: Yang Gyoon
authors: YG
authors: Kim
authors: Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: Joo Young
authors: JY
authors: Moon
authors: Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: Sang Ho
authors: SH
authors: Lee
authors: Division of Cardiology, Department of Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.
authors: Myung Ho
authors: MH
authors: Jeong
authors: Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: Kyung Hwan
authors: KH
authors: Jeong
mesh_terms: D000208:Acute Disease; D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood*; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D011379:Prognosis; D014280:Triglycerides / Q000097:blood*
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides