Association between triglycerides to high-density lipoprotein cholesterol ratio and death risk in diabetic patients with new-onset acute coronary syndrome：a retrospective cohort study in Han Chinese population

Background and Aims: The incidence of diabetes mellitus has reached an alarming level. Cardiovascular disease (CVD) is the leading cause of mortality in diabetic patients. However, the association between ratio and survival outcomes in patients with diabetes mellitus (DM) and new-onset acute coronary syndrome (ACS) remains unknown. The study aimed to assess the association between TG/HDLC ratio and the death risk in diabetic patients with new-onset acute coronary syndrome in Han Chinese population. Methods: : Data in this study were retrospectively collected from January 2016 to December 2016 from patients with type 2 diabetes mellitus(T2DM) and new-onset ACS in Tianjin Chest Hospital. Patients were classified according to the baseline TG/HDLC ratio. The Kaplan-Meier survival curve showed survival outcomes. Univariate and multivariate Cox proportional risk regression analyses were used to evaluate the hazard ratios and 95% confidence intervals (CIs) of death risk. Subgroup analysis was used to determine whether there was an interaction. Results: : In total, 152 patients died, 98 of them from heart disease. The Kaplan-Meier survival curve showed that the group with a high TG/HDLC ratio has a higher mortality rate than the group with a low TG/HDLC ratio. Multivariate Cox regression analyses revealed that the adjusted hazard ratio increased significantly with increasing TG/HDLC median (P <0.05) for all-cause mortality and cardiac death. The association between TG/HDLC ratio and the risks of all-cause mortality and cardiac death in diabetic patients with new-onset ACS was similar among subgroups (P for interaction>0.05). Conclusion: Increased TG/HDLC ratio is significantly associated with higher all-cause and cardiac death risks in diabetic patients with new-onset ACS. Therefore, TG/HDLC ratio may be beneficial to evaluate the prognosis of this high-risk population.