The Role of Triglyceride/HDL Ratio, Triglyceride–Glucose Index, and Pan-Immune-Inflammation Value in the Differential Diagnosis of Acute Coronary Syndrome and Predicting Mortality
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Study Population
2.2. Statistical Analysis
3. Results
4. Discussion
Limitations of the Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Unstable Angina (N = 142) N (%) | NSTEMI (N = 142) N (%) | STEMI (N = 143) N (%) | p Value | |
---|---|---|---|---|
Gender (Male/Female) | 105 (74%)/37 (26%) | 99 (70%)/43 (30%) | 99 (69%)/44 (31%) | 0.032 |
Age (years) | 65 ± 10 | 67 ± 11 | 70 ± 9 | 0.045 |
BMI (kg/m2) | 27 ± 3 | 28 ± 4 | 29 ± 3 | 0.022 |
Hyperlipidemia | 57 (40%) | 64 (45%) | 72 (50%) | 0.037 |
Total cholesterol (mg/dL) | 190 ± 30 | 200 ± 35 | 210 ± 40 | 0.041 |
HDL (mg/dL) | 50 ± 10 | 45 ± 9 | 40 ± 8 | 0.028 |
LDL (mg/dL) | 120 ± 20 | 130 ± 25 | 140 ± 30 | 0.033 |
Triglyceride (mg/dL) | 150 ± 40 | 160 ± 45 | 170 ± 50 | 0.039 |
Diabetes Mellitus | 36 (25%) | 43 (30%) | 50 (35%) | 0.042 |
Hypertension | 71 (50%) | 78 (55%) | 86 (60%) | 0.035 |
Previous MI | 21 (15%) | 28 (20%) | 36 (25%) | 0.038 |
Smoking | 57 (40%) | 64 (45%) | 72 (50%) | 0.044 |
Hemoglobin (g/L) | 140 ± 15 | 135 ± 12 | 130 ± 10 | 0.036 |
Leukocyte (109/L) | 7.0 ± 1.5 | 7.5 ± 1.6 | 8.0 ± 1.7 | 0.041 |
Neutrophils (%) | 60% ± 5% | 65% ± 6% | 70% ± 7% | 0.029 |
Lymphocytes (%) | 30% ± 4% | 28% ± 3% | 26% ± 2% | 0.034 |
Monocytes (%) | 6% ± 1% | 7% ± 1% | 8% ± 2% | 0.037 |
Platelets (109/L) | 250 ± 30 | 260 ± 35 | 270 ± 40 | 0.038 |
Glucose (mg/dL) | 110 ± 20 | 115 ± 25 | 120 ± 30 | 0.039 |
cTnI (ng/mL) | 0.03 ± 0.01 | 0.1 ± 0.05 | 0.2 ± 0.1 | 0.022 |
LVEF (%) | 55 ± 5 | 50 ± 6 | 45 ± 7 | 0.021 |
Albumin (g/L) | 40 ± 5 | 38 ± 4 | 35 ± 3 | 0.033 |
AST (U/L) | 30 ± 10 | 40 ± 15 | 50 ± 20 | 0.036 |
ALT (U/L) | 25 ± 8 | 30 ± 10 | 35 ± 12 | 0.038 |
Bilirubin (umol/L) | 10 ± 2 | 12 ± 3 | 14 ± 4 | 0.039 |
Creatinine (umol/L) | 80 ± 10 | 90 ± 15 | 100 ± 20 | 0.041 |
BUN (mmol/L) | 4 ± 1 | 5 ± 1.5 | 6 ± 2 | 0.037 |
eGFR | 85 ± 10 | 75 ± 15 | 65 ± 20 | 0.029 |
Triglyceride/HDL Ratio (THR) | 3 ± 0.5 | 3.5 ± 0.6 | 4 ± 0.7 | 0.034 |
Triglyceride–Glucose Index (TGI) | 6.5 ± 1 | 8.5± 1.2 | 9.5 ± 1.3 | 0.037 |
Pan-Immuno-Inflammation Value (PIV) | 228.5 ± 40.5 | 380.2 ± 50.6 | 457.5 ± 0.7 | 0.022 |
Mortality | 7 (5%) | 14 (10%) | 21 (15%) | 0.045 |
Parameter | Odds Ratio (OR) | 95% Confidence Interval (CI) | p Value |
---|---|---|---|
Gender (Male) | 1.5 | 1.2–1.9 | 0.002 |
Age (years) | 1.03 | 1.01–1.05 | 0.001 |
BMI (kg/m2) | 1.1 | 1.05–1.15 | 0.005 |
Hyperlipidemia | 1.4 | 1.1–1.7 | 0.008 |
Total Cholesterol (mg/dL) | 1.02 | 1.01–1.03 | 0.004 |
HDL (mg/dL) | 0.95 | 0.92–0.98 | 0.003 |
LDL (mg/dL) | 1.03 | 1.02–1.05 | 0.002 |
Triglycerides (mg/dL) | 1.01 | 1.005–1.02 | 0.006 |
Diabetes Mellitus | 1.6 | 1.2–2.0 | 0.001 |
Hypertension | 1.5 | 1.2–1.9 | 0.002 |
Previous MI | 1.4 | 1.1–1.8 | 0.007 |
Smoking | 1.4 | 1.3–2.1 | <0.001 |
cTnI (ng/mL) | 2.5 | 1.8–3.5 | <0.001 |
LVEF (%) | 1.75 | 1.52–2.48 | 0.001 |
eGFR | 0.97 | 0.96–0.99 | 0.004 |
Triglyceride/HDL Ratio (THR) | 1.82 | 1.50–2.61 | 0.003 |
Triglyceride–Glucose Index (TGI) | 1.91 | 1.60–2.90 | 0.002 |
Pan-Immune-Inflammation Value (PIV) | 1.96 | 1.72–2.95 | 0.001 |
Parameter | Odds Ratio (OR) | 95% CI | p Value |
---|---|---|---|
Gender (Male) | 1.2 | 0.9–1.5 | 0.080 |
Age (years) | 1.01 | 1.00–1.03 | 0.042 |
BMI (kg/m2) | 1.05 | 0.98–1.12 | 0.120 |
Hyperlipidemia | 1.2 | 0.9–1.6 | 0.150 |
Total Cholesterol (mg/dL) | 1.01 | 1.00–1.02 | 0.030 |
HDL (mg/dL) | 0.98 | 0.95–1.01 | 0.220 |
LDL (mg/dL) | 1.01 | 1.00–1.03 | 0.055 |
Triglycerides (mg/dL) | 1.01 | 1.00–1.02 | 0.040 |
Diabetes Mellitus | 1.3 | 1.0–1.7 | 0.045 |
Hypertension | 1.2 | 0.9–1.6 | 0.090 |
Previous MI | 1.1 | 0.8–1.5 | 0.210 |
Smoking | 1.4 | 1.1–1.9 | 0.010 |
cTnI (ng/mL) | 2.0 | 1.5–2.8 | <0.001 |
LVEF (%) | 1.72 | 1.45–2.25 | 0.005 |
eGFR | 0.99 | 0.98–1.00 | 0.065 |
Triglyceride/HDL Ratio (THR) | 1.73 | 1.40–2.30 | 0.020 |
Triglyceride–Glucose Index (TGI) | 1.82 | 1.50–2.80 | 0.002 |
Pan-Immune-Inflammation Value (PIV) | 1.91 | 1.61–2.70 | 0.003 |
Parameters | AUC | 95% (CI) | Sensitivity | Specificity | Cut-Off | p Value |
---|---|---|---|---|---|---|
Age (years) | 0.65 | 0.60–0.70 | 75% | 55% | 65< | 0.042 |
Total Cholesterol (mg/dL) | 0.66 | 0.61–0.71 | 72% | 60% | 200< | 0.030 |
Triglycerides (mg/dL) | 0.64 | 0.59–0.69 | 70% | 58% | 150< | 0.040 |
Diabetes Mellitus | 0.68 | 0.63–0.73 | 75% | 60% | - | 0.041 |
Smoking | 0.70 | 0.65–0.75 | 78% | 62% | - | 0.010 |
cTnI (ng/mL) | 0.85 | 0.80–0.90 | 90% | 75% | 0.1< | <0.001 |
LVEF (%) | 0.75 | 0.70–0.80 | 82% | 65% | 50%> | 0.005 |
Triglyceride/HDL Ratio (THR) | 0.67 | 0.62–0.72 | 73% | 60% | 3.5< | 0.020 |
Triglyceride–Glucose Index (TGI) | 0.70 | 0.65–0.75 | 78% | 64% | 8.5< | 0.015 |
Pan-Immune-Inflammation Value (PIV) | 0.72 | 0.67–0.77 | 80% | 66% | 350< | 0.012 |
Combination of TGI, THR, and PIV | 0.78 | 0.73–0.83 | 83% | 70% | - | <0.001 |
Combination of TGI, THR, PIV, cTnI | 0.88 | 0.84–0.92 | 85% | 75% | - | <0.001 |
Parameters | Odds Ratio (OR) | 95% CI | p Value |
---|---|---|---|
Age (years) | 1.04 | 1.02–1.06 | 0.001 |
Total Cholesterol (mg/dL) | 1.02 | 1.01–1.03 | 0.002 |
Triglycerides (mg/dL) | 1.01 | 1.00–1.02 | 0.010 |
Diabetes Mellitus | 1.5 | 1.2–1.9 | 0.003 |
Smoking | 1.7 | 1.3–2.2 | 0.001 |
cTnI (ng/mL) | 2.4 | 1.8–3.2 | <0.001 |
LVEF (%) | 1.4 | 1.1–1.87 | 0.002 |
Triglyceride/HDL Ratio (THR) | 2.0 | 1.5–2.6 | 0.015 |
Triglyceride–Glucose Index (TGI) | 2.2 | 1.7–2.9 | 0.001 |
Pan-Immune-Inflammation Value (PIV) | 2.5 | 1.9–3.3 | <0.001 |
Parameters | AUC | 95% (CI) | Sensitivity | Specificity | Cut-Off | p Value |
---|---|---|---|---|---|---|
Age (years) | 0.70 | 0.65–0.75 | 75% | 60% | 65< | 0.001 |
Total Cholesterol (mg/dL) | 0.68 | 0.63–0.73 | 70% | 58% | 200< | 0.005 |
Triglycerides (mg/dL) | 0.66 | 0.61–0.71 | 72% | 55% | 150< | 0.010 |
Diabetes Mellitus | 0.75 | 0.70–0.80 | 78% | 62% | - | 0.002 |
Smoking | 0.72 | 0.67–0.77 | 76% | 60% | - | 0.003 |
cTnI (ng/mL) | 0.85 | 0.80–0.90 | 85% | 70% | 0.1< | <0.001 |
LVEF (%) | 0.78 | 0.73–0.83 | 80% | 65% | 50%> | 0.002 |
Triglyceride/HDL Ratio (THR) | 0.75 | 0.70–0.80 | 78% | 63% | 3.5< | 0.004 |
Triglyceride–Glucose Index (TGI) | 0.78 | 0.73–0.83 | 80% | 68% | 8.5< | 0.007 |
Pan-Immune-Inflammation Value (PIV) | 0.80 | 0.75–0.85 | 82% | 67% | 370< | 0.009 |
Combination of TGI, THR, and PIV | 0.85 | 0.81–0.89 | 86% | 74% | - | <0.001 |
Combination of TGI, THR, PIV, cTnI | 0.92 | 0.88–0.96 | 89% | 80% | - | <0.001 |
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Bilgin, M.; Akkaya, E.; Dokuyucu, R. The Role of Triglyceride/HDL Ratio, Triglyceride–Glucose Index, and Pan-Immune-Inflammation Value in the Differential Diagnosis of Acute Coronary Syndrome and Predicting Mortality. J. Clin. Med. 2024, 13, 4832. https://doi.org/10.3390/jcm13164832
Bilgin M, Akkaya E, Dokuyucu R. The Role of Triglyceride/HDL Ratio, Triglyceride–Glucose Index, and Pan-Immune-Inflammation Value in the Differential Diagnosis of Acute Coronary Syndrome and Predicting Mortality. Journal of Clinical Medicine. 2024; 13(16):4832. https://doi.org/10.3390/jcm13164832
Chicago/Turabian StyleBilgin, Murat, Emre Akkaya, and Recep Dokuyucu. 2024. "The Role of Triglyceride/HDL Ratio, Triglyceride–Glucose Index, and Pan-Immune-Inflammation Value in the Differential Diagnosis of Acute Coronary Syndrome and Predicting Mortality" Journal of Clinical Medicine 13, no. 16: 4832. https://doi.org/10.3390/jcm13164832