The triglyceride/HDL cholesterol ratio and TyG index predict coronary atherosclerosis and outcome in the general population
Alberto Aimo, Sara Chiappino, Alberto Clemente, Daniele Della Latta, Nicola Martini, Georgios Georgiopoulos, Giorgia Panichella, Valeria Piagneri, Simona Storti, Angelo Monteleone, Claudio Passino, Dante Chiappino, Michele Emdin, Alessia Gimelli, Danilo Neglia
Abstract
The combination of increased plasma triglycerides (TGs) and low high-density lipoprotein cholesterol (HDL-C) is an emerging marker of ‘atherogenic dyslipidaemia’ and risk of cardiovascular events in the general population.1 The TG-glucose (TyG) index is calculated as Ln(TG*FPG/2).2 It predicted cardiac events in the general population,3 and the progression of coronary atherosclerosis in patients with known coronary artery disease,4 irrespective of other risk factors, or cholesterol levels. In a cohort from the general population, we investigated specifically the interplay between TG-related indices, findings from non-contrast computed tomography (CT) and patient outcome. From CT scans, epicardial fat volume (EFV) and coronary artery calcium (CAC) score were derived. Epicardial fat is a biologically active organ that surrounds the coronary arteries and promote the development of coronary atherosclerosis.5 EFV then becomes a surrogate indicator of the lipid-rich coronary plaque burden, and then of high-risk atherosclerotic plaques, while the CAC score expresses more stable and calcific coronary atherosclerosis. EFV may have also a prognostic value for future adverse events also beyond CAC scoring.6