{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T22:29:19Z","timestamp":1782167359371,"version":"3.54.5"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:00:00Z","timestamp":1649808000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Several studies have reported that the combination of high TG and low HDL-C, as simplified by the TG\/HDL-C ratio, was a predictor of cardiovascular disease independent of LDL-C level. Nevertheless, poor data are available on the predictive role of TG\/HDL-C ratio in very high risk (VHR) patients with chronic coronary syndromes (CCS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the data from the STable Coronary Artery Diseases RegisTry (START) study, an Italian nationwide registry, we assessed the association between the TG\/HDL-C ratio and baseline clinical characteristics, pharmacological treatment, and major adverse cardio-cerebrovascular events (MACCE) at 1 year in a large cohort of CCS patients at VHR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>VHR patients with both TG and HDL-C levels available were grouped in tertiles of TG\/HDL-C ratio: low (TG\/HDL-C ratio &amp;lt;2, <jats:italic>n<\/jats:italic> = 967), middle (TG\/HDL-C ratio 2\u20133.3, <jats:italic>n<\/jats:italic> = 1,071) and high (TG\/HDL-C ratio &amp;gt;3.3, <jats:italic>n<\/jats:italic> = 1,028). At 1 year from enrolment, 232 (7.6%) patients presented a MACCE, with a higher incidence in the higher tertile, even though not statistically significant (6.0, 8.2, and 8.4% in the low, middle and high tertile, respectively; <jats:italic>p<\/jats:italic> = 0.08). At multivariable analysis, the TG\/HDL-C ratio in tertiles did not result an independent predictor of the MACCE (<jats:italic>p<\/jats:italic> = 0.29) at 1-year follow-up (HR: 1.30; 95% CI: 0.93\u20131.82; <jats:italic>p<\/jats:italic> = 0.12 middle vs. lower tertile, and HR: 1.22; 95% CI: 0.87\u20131.72; <jats:italic>p<\/jats:italic> = 0.25 higher vs. lower).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the present large, nationwide cohort of CCS patients at VHR a high TG\/HD ratio did not emerge as independent predictor of MACCE at 1 year. Further studies with a longer follow-up are needed to better define the prognostic role of TG\/HDL ratio in CCS.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.874087","type":"journal-article","created":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T06:20:07Z","timestamp":1649830807000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Clinical Impact and Prognostic Role of Triglyceride to High-Density Lipoprotein Cholesterol Ratio in Patients With Chronic Coronary Syndromes at Very High Risk: Insights From the START Study"],"prefix":"10.3389","volume":"9","author":[{"given":"Leonardo","family":"De Luca","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier 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