Fasting Blood Glucose to High-Density Lipoprotein Cholesterol Ratio in Relation to Short-Term Outcomes in Patients with Acute Coronary Syndrome

Abstract BackgroundBiochemical markers are crucial for determining risk in patients with coronary artery disease (CAD); however, the association between the fasting blood glucose to high-density lipoprotein cholesterol (FG/HDL-C) ratio and short-term outcomes in patients with acute coronary syndrome (ACS) remains unknown. We investigated the association between the FG/HDL-C ratio and 30-day major adverse cardiovascular events (MACEs) and cardiovascular (CV) death in patients with ACS.eMethodsWe performed a post-hoc analysis of data from the Acute Coronary Syndrome Quality Improvement in Kerala (ACS-QUIK) study. A total of 11,284 patients with ACS were subdivided into quartiles according to their FG/HDL-C ratios. We used a multivariate logistic regression model, generalized additive model (GAM), and two-piecewise linear regression model to determine the association of the FG/HDL-C ratio with MACEs (death, reinfarction, stroke, and major bleeding) and CV death. ResultsThe FG/HDL-C ratio was significantly associated with an increased risk of MACEs and CV death in patients with ACS in the highest quartile (MACEs, odds ratio [OR]: 1.49; 95% confidence interval [CI], [1.11, 1.99]; P<0.01; CV death, OR: 1.69; 95% CI, [1.01, 1.41]; P=0.04). The GAM and two-piecewise linear regression model demonstrated that the relationship between the FG/HDL-C ratio and MACEs and CV death was non-linear (non-linear P<0.05); the threshold values were 3.02 and 3.00 for MACEs and CV death, respectively.ConclusionsA higher FG/HDL-C ratio is associated with an increased risk of MACEs and CV death in patients with ACS.