Investigation of the Predictive Values of Triglyceride/HDL Cholesterol Ratio and Whole Blood Viscosity with Regard to Severe Peripheral or Carotid Artery Disease in Patients Scheduled for Coronary Bypass

Severe Additional Arterial Disease Predictors in Patients with Coronary Artery Disease

Authors

  • Mesut Engin, MD Department of Cardiovascular Surgery, University of Health Sciences, Mehmet Akif İnan Training and Research Hospital, Şanlıurfa, Turkey
  • Orhan Güvenç, MD Department of Cardiovascular Surgery, Medical Faculty of Uludağ University, Bursa, Turkey

DOI:

https://doi.org/10.1532/hsf.2991

Keywords:

Coronary artery disease, Peripheral artery disease, Carotid artery disease, Cholesterol, Blood viscosity

Abstract

Background: The incidence of atherosclerotic cardiovascular diseases, which constitute an important disease group, is expected to rise with increasing life expectancy. The aim of this study was to investigate the predictive values of triglyceride/HDL cholesterol (TG/HDL-C) ratio and whole blood viscosity on possible severe carotid or peripheral arterial disease in patients who were admitted to our clinic and scheduled for coronary artery bypass graft (CABG) surgery.

Methods: This study retrospectively examined 299 patients who were admitted to our clinic and scheduled for CABG between August 1, 2015, and August 1, 2019. Patients with severe carotid or peripheral arterial disease were included in group 2; those in whom peripheral arterial disease and stenosis were not detected were included in group 1.

Results: Group 1 consisted of 255 patients, mean (± standard deviation) age 58.1 ± 8.9 years; the 44 patients in group 2 had a mean age of 64.1 ± 10.6 years (P = .018). The incidence of diabetes mellitus and tobacco use were significantly higher in group 2 (P < .001 and P = .034, respectively).
Triglyceride values, TG/HDL-C, and whole blood viscosity at high and low shear rates were significantly higher in group 2 (P = .017, P < .001, P < .001, and P < .001, respectively). Receiver operator characteristic analysis revealed that the cutoff value of TG/HDL-C was 3.2 with 77% sensitivity and 72% specificity; that of high-shear-rate viscosity was 16.1 with 73% sensitivity and 69% specificity; and that of low-shear-rate viscosity was 59.2 with 70% sensitivity and 63% specificity.

Conclusion: It is possible to predict severe additional arterial diseases in patients scheduled for CABG with whole blood viscosity and TG/HDL-C ratios, both of which can be obtained with simple blood tests.

References

Asia Pacific Cohort Studies Collaboration. 2005. A comparison of lipid variables as predictors of cardiovascular disease in the Asia Pacific Region. Ann Epidemiol 15:405-413.

Calabresi L, Gomaraschi M, Franceschini G. 2003. Endothelial protection by high-density lipoproteins: From bench to bedside. Arterioscler Thromb Vasc Biol 23:1724-1731.

Cecchi E, Giglioli C, Valente S, et al. 2011. Role of hemodynamic shear stress in cardiovascular disease. Atherosclerosis 214:249-256

Cetin EH, Cetin MS, Canpolat U, et al. 2016a. Prognostic significance of whole blood viscosity estimated by de Simone’s formula in ST-elevation myocardial infarction. Biomark Med 10:495-511.

Cetin MS, Çetin EHÖ, Balcı KG, et al. 2016b. The association between whole blood viscosity and coronary collateral circulation in patients with chronic total occlusion. Korean Circ J 46:784-790.

Chang TI, Streja E, Soohoo M, et al. 2017. Association of serum triglyceride to HDL cholesterol ratio with all-cause and cardiovascular mortality in incident hemodialysis patients. Clin J Am Soc Nephrol 12:591-602.

Chen Z, Chen G, Qin H, et al. 2020. Higher triglyceride to high-density lipoprotein cholesterol ratio increases cardiovascular risk: 10-year prospective study in a cohort of Chinese adults. J Diabetes Investig 11:475-481.

Chi C, Teliewubai J, Lu YY, et al. 2018. Comparison of various lipid parameters in association of target organ damage: A cohort study. Lipids Health Dis 17:199.

Cuchel M, Rader DJ. 2006. Macrophage reverse cholesterol transport: Key to the regression of atherosclerosis? Circulation 113:2548-2555.

Di Angelantonio E, Sarwar N, Perry P, et al. 2009. Emerging Risk Factors Collaboration. Major lipids, apolipoproteins, and risk of vascular disease. JAMA 302:1993-2000.

Frohlich J and Dobiasova M. 2003. Fractional esterifcation rate of cholesterol and ratio of triglycerides to HDL-cholesterol are powerful predictors of positive findings on coronary angiography. Clin Chem 49:1873-1880.

Hillis LD, Smith PK, Anderson JL, et al. 2011. 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 124:e652-e735.

Kim J, Chung H, Cho M, et al. 2013. The role of critical shear stress on acute coronary syndrome. Clin Hemorheol Microcirc 55:101-109.

Lowe GD, Lee AJ, Rumley A, et al. 1997. Blood viscosity and risk of cardiovascular events: The Edinburgh Artery Study. Br J Haematol 96:168-173.

Lowe G, Rumley A, Norrie J, et al. 2000. Blood rheology, cardiovascular risk factors, and cardiovascular disease: The West of Scotland Coronary Prevention Study. Thromb Haemost 84:553-558.

Marossy A, Svorc P, Kron I, Gresová S. 2009. Hemorheology and circulation. Clin Hemorheol Microcirc 42:239-258.

Norgren L, Hiatt WR, Dormandy JA, et al. 2007. TASC II Working Group. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg 45(suppl S):S5-S67.

Nwose EU. 2010. Cardiovascular risk assessment and support techniques: Whole blood viscosity assessment issues I: extrapolation chart and reference values. North Am J Med Sci 2:165-169.

Ozcan Cetin EH, Cetin MS, Canpolat U et al. 2015. The forgotten variable of shear stress in mitral annular calcifcation: Whole blood viscosity. Med Princ Pract 24:444-450.

Puri R, Nissen SE, Shao M, et al. 2016. Non-HDL cholesterol and triglycerides: Implications for coronary atheroma progression and clinical events. Arterioscler Thromb Vasc Biol 36:2220-2228.

Salazar Vázquez BY, Martini J, Chávez Negrete A, et al. 2010. Cardiovascular benefits in moderate increases of blood and plasma viscosity surpass those associated with lowering viscosity: Experimental and clinical evidence. Clin Hemorheol Microcirc 44:75-85.

Sarwar N, Danesh J, Eiriksdottir G, et al. 2007. Triglycerides and the risk of coronary heart disease: 10,158 incident cases among 262,525 participants in 29 Western prospective studies. Circulation 115:450-458.

Sloop G, Holsworth RE Jr, Weidman JJ, St Cyr JA. 2015. The role of chronic hyperviscosity in vascular disease. Ther Adv Cardiovasc Dis 9:19-25.

Te Kolste HJ, Balm R, de Mol B. 2015. Acute compartment syndrome of the lower leg after coronary artery bypass grafting: A silent but dangerous complication. Thorac Cardiovasc Surg 63:300-306.

Teker Açıkel ME, Korkut AK. 2019. Impact of Controlling Nutritional Status Score (CONUT) and Prognostic Nutritional Index (PIN) on patients undergoing coronary artery bypass graft surgery. Heart Surg Forum 22:E294-E297.

Xing Y, Guo JT, Gai LY, et al. 2019. Association of uric acid and C-reactive protein with the severity of coronary artery disease using SYNTAX Score and Clinical SYNTAX Score. Heart Surg Forum 22:E247-E252.

Published

2020-05-14

How to Cite

Engin, M., & Güvenç, O. (2020). Investigation of the Predictive Values of Triglyceride/HDL Cholesterol Ratio and Whole Blood Viscosity with Regard to Severe Peripheral or Carotid Artery Disease in Patients Scheduled for Coronary Bypass: Severe Additional Arterial Disease Predictors in Patients with Coronary Artery Disease. The Heart Surgery Forum, 23(3), E310-E314. https://doi.org/10.1532/hsf.2991

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