Relationship Between TG/ HDL Cholesterol Ratio and Angiographic Sevrrty in Patients With STEMI

Abstract

Background: Coronary artery disease (CAD) is a major cause of morbidity and mortality, and the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio may reflect an atherogenic metabolic profile associated with coronary disease burden. Objective: To determine the relationship between the TG/HDL-C ratio and angiographic severity of CAD among patients with ST-elevated myocardial infarction (STEMI). Method: This cross-sectional observational study was conducted among 73 patients with STEMI at the Department of Cardiology, Sylhet MAG Osmani Medical College Hospital, from July 2019 to June 2021. Patients were categorized according to TG/HDL-C ratio as <4 or ≥4. Coronary angiographic severity was assessed using vessel score and Gensini score. Data were analyzed using SPSS version 25.0, with p<0.05 considered statistically significant. Results: The mean age was 51.03±10.47 years and 84.9% were male. Hypertension was significantly more frequent in the high TG/HDL-C group (66.0% vs. 34.8%, p=0.013). The high-ratio group had significantly higher random blood glucose, serum creatinine, LDL-C and triglyceride levels and lower HDL-C levels. TG/HDL-C showed a strong positive correlation with Gensini score (ρ=0.735, p=0.0001) and a significant positive correlation with vessel score (ρ=0.447, p=0.0001). Severe CAD was more frequent among patients with TG/HDL-C ≥4 (86.0% vs. 8.7%, p=0.0001). Multivariate analysis showed significant associations of severe CAD with diabetes mellitus (OR=7.299), hypertension (OR=6.065), and TG/HDL-C ≥4 (OR=158.594). Conclusion: A higher TG/HDL-C ratio was significantly associated with greater angiographic severity of CAD in patients with STEMI and may serve as a simple marker of increased coronary atherosclerotic burden.