Association between the Non-high-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratio and the Risk of Coronary Artery Disease

Background. The purpose of this study was to evaluate the association between the non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) ratio and the risk of coronary artery disease (CAD). We also explored the potential role of non-HDL-C/HDL-C in the prognosis of CAD. Methods. We analyzed 930 consecutive patients with chest discomfort who underwent coronary angiography. Of these, 680 were diagnosed with CAD; the remaining 250 patients were normal. Multivariate logistic regression and receiver operating characteristic (ROC) curves were employed to evaluate the association between non-HDL-C/HDL-C and CAD. The effect of non-HDL-C/HDL-C on the progression of major adverse cardiovascular events (MACEs) was also explored. Results. Increased non-HDL-C/HDL-C was associated with an increased risk of CAD (OR: 1.291; 95% CI: 1.039-1.561; P=0.013). The results of stratified analyses by CAD subtype showed a correlation between high non-HDL-C/HDL-C and increased risk of acute coronary syndrome (OR: 1.661; 95% CI: 1.259-2.207; P<0.001), high Gensini score (OR: 1.408; 95% CI: 1.021-1.935; P=0.039), and multivessel disease (OR: 1.487; 95% CI: 1.128-1.992; P=0.007). Moreover, the areas under the ROC for the predictive value of non-HDL-C/HDL-C for CAD, acute coronary syndrome, high Gensini score, and multivessel disease were 0.604, 0.658, 0.642, and 0.636, respectively. Non-HDL-C/HDL-C in CAD patients was significantly correlated with the risk of long-term MACEs (P=0.004). Conclusions. The findings of this study indicated that non-HDL-C/HDL-C plays an important role in the risk and progression of CAD. These findings need verification by further large-scale prospective studies.