LDL-C /HDL-C ratio better predicts coronary artery disease severity in STEMI patients: Study
China: In patients with STEMI, the LDL-C/HDL-C ratio is more correlated with the severity of coronary artery disease as compared to the ratios of non-HDL-C and LDL-C, reveals a study published in BMC Cardiovascular Disorders.
The researchers further add that "the LDL-C/HDL-C ratio can better predict whether patients with chest pain are ST-segment elevation myocardial infarction (STEMI) and better evaluate the severity of coronary artery disease."
In the occurrence of atherosclerosis, the increase of low-density lipoprotein cholesterol (LDL-C) is widely accepted as an important factor. The guideline in recent years has recommended non-high-density lipoprotein cholesterol (non-HDL-C) as a secondary target for lipid-lowering therapy. But despite increases in the research on the relationship between LDL-C/HDL-C and atherosclerosis, which index is most closely related to the severity of acute STEMI remains undetermined.
Against the above background, Po Gao, Hefei Hospital Affiliated to Anhui Medical University, Hefei, China, and colleagues aimed to explore the evaluative effect of the above two indicators on the severity of coronary artery disease in STEMI patients, both weighing which of the two indicators evaluates severity more effectively, and identifying the boundary value that requires intervention.
For this purpose, the researchers included 901 patients who received coronary angiography due to chest pain. 772 patients with STEMI represented the test group and 129 patients with basically normal coronary angiography represented the control group. Measurement of their fasting blood lipids and other indicators was done after admission, and the severity of coronary artery disease was determined using the Gensini score.
Based on the study, the researchers reported the following findings:
· LDL-C/HDL-C and non-HDL-C indexes were statistically different between the two patient groups.
· In the test group, total cholesterol (TC), triglycerides (TG), LDL-C, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, arteriosclerosis index (AI), and LDL-C/HDL-C all correlated with the patients' Gensini score.
· After applying the stepwise method of multiple linear regression analysis, LDL-C/HDL-C had the most correlation with the patient's Gensini score.
· ROC curve analysis suggested that LDL-C/HDL-C can predict whether patients with chest pain are STEMI.
· When the cutoff value is 2.15, sensitivity is 0.845, and specificity is 0.202, LDL-C/HDL-C is an effective indicator for predicting whether patients with chest pain have STEMI.
The researchers conclude, "we found that LDL-C/HDL-C works more effectively than non-HDL-C in evaluating the severity of coronary artery disease in STEMI patients and also in predicting whether patients with chest pain are STEMI."
Reference:
Gao, P., Wen, X., Ou, Q. et al. Which one of LDL-C /HDL-C ratio and non-HDL-C can better predict the severity of coronary artery disease in STEMI patients. BMC Cardiovasc Disord 22, 318 (2022). https://doi.org/10.1186/s12872-022-02760-0
