Baseline characteristics of participants
All patients were subdivided into four quartiles according to the FG/HDL-C ratio levels. Table 1 shows the baseline characteristics of the study population according to the FG/HDL-C ratio quartiles. Briefly, a total of 11,284 patients (8,568 male patients and 2,716 female patients) were available for the final baseline analysis. Their age was 60.11 ± 12.05 years; 5,202 patients (46.10%) had a history of hypertension, and 5,396 (47.82%) had a history of diabetes. The FG/HDL-C ratio was 3.75 ± 2.05. There were statistically significant differences (P < 0.05) among the four quartiles in terms of intervention, sex, age, heart rate, weight, SBP, hemoglobin, sCr, HDL-C, LDL-C, TRIG, FG, smoking or tobacco, hypertension, PAD, diabetes, STEMI, heart failure, cardiac shock, Killip class, LVEF category, angiography, PCI, and the use of medications including clopidogrel, ticagrelor, beta-blocker, ACEI, and ARB. No statistically significant differences were found for the other indicators. Patients with FG/HDL-C ratio levels in the highest quartile had higher levels of sCr and FG and lower levels of HDL-C and LDL-C, had a higher incidence of hypertension, PAD, diabetes, heart failure, and cardiac shock, and fewer of them smoked.
Relationship between FG/HDL-C ratio and adverse outcomes
The multivariable stepwise analysis of the three models (non-adjusted model, minor-adjusted model, and fully adjusted model) is shown in Tables 2. The FG/HDL-C ratio was significantly associated with an increased risk of MACEs in patients in the highest quartile (non-adjusted model, odds ratio [OR]: 1.42; 95% confidence interval [CI], [1.10, 1.82]; P < 0.01) (minor-adjusted model, OR: 1.57; 95% CI, [1.21, 2.03]; P < 0.01) (fully adjusted model, OR: 1.49; 95% CI, [1.11, 1.99]; P < 0.01). Regarding CV death, patients in the highest quartile had the highest risk (non-adjusted model, OR: 1.56; 95% CI, [1.16, 2.10]; P < 0.01) (minor-adjusted model, OR: 1.77; 95% CI, [1.30, 2.39]; P < 0.01) (fully adjusted model, OR: 1.69; 95% CI, [1.01, 1.41); P = 0.04) compared with those in the lowest quartile. When we used the FG/HDL-C ratio as a continuous covariate, in the non-adjusted model, the risk of MACEs and CV death increased as the FG/HDL-C ratio increased (MACEs, OR: 1.09; 95% CI, [1.05, 1.13]; P < 0.01) (CV death, OR: 1.11; 95% CI, [1.07, 1.16); P < 0.01). In the minor-adjusted model, there was no significant change in the results after adjustment (MACEs, OR: 1.10; 95% CI, [1.06, 1.15]; P < 0.01) (CV death, OR: 1.13; 95% CI, [1.08, 1.18); P < 0.01). In the fully adjusted model, fully adjusting for confounders also did not change the trend (MACEs, OR: 1.09; 95% CI, [1.04, 1.14]; P < 0.01) (CV death, OR: 1.11; 95% CI, [1.04, 1.19); P < 0.01).
Table 2. Relationship between the FG/HDL-C ratio and short-term outcomes in different models.
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MACEs
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Exposure
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Non-adjusted
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Minor-adjusted
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Fully adjusted
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FG/HDL-C ratio
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1.09 (1.05, 1.13), P < 0.01
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1.10 (1.06, 1.15), P < 0.01
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1.09 (1.04, 1.14), P < 0.01
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FG/HDL-C ratio grouping
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|
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Q1
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Ref
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Ref
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Ref
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Q2
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0.93 (0.70, 1.22), P = 0.58
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0.95 (0.72, 1.26), P = 0.75
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0.98 (0.73, 1.30), P = 0.88
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Q3
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0.89 (0.68, 1.18), P = 0.43
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1.00 (0.76, 1.33), P = 0.98
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1.03 (0.76, 1.38), P = 0.86
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Q4
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1.42 (1.10, 1.82), P < 0.01
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1.57 (1.21, 2.03), P < 0.01
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1.49 (1.11, 1.99), P < 0.01
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|
CV death
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|
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Exposure
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Non-adjusted
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Minor-adjusted
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Fully adjusted
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FG/HDL-C ratio
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1.11 (1.07, 1.16), P < 0.01
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1.13 (1.08, 1.18), P < 0.01
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1.11 (1.04, 1.19), P < 0.01
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FG/HDL-C ratio grouping
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|
|
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Q1
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Ref
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Ref
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Ref
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Q2
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0.95 (0.68, 1.31), P = 0.74
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0.98 (0.70, 1.38), P = 0.92
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1.01 (0.59, 1.71), P = 0.98
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Q3
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0.82 (0.58, 1.15), P = 0.26
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0.94 (0.66, 1.33), P = 0.71
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0.83 (0.48, 1.46), P = 0.53
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Q4
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1.56 (1.16, 2.10), P < 0.01
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1.77 (1.30, 2.39), P < 0.01
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1.69 (1.01, 1.41), P = 0.04
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Co-linearity analysis showed that FG, cardiac arrest, PCI, CABG and FG/HDL-C ratio had high co-linearity. Therefore, FG, cardiac arrest, PCI, and CABG weren’t included in multivariate model.
For MACEs, in the non-adjusted model, we did not adjust other covariates. In the minor-model, we adjusted for cohort, intervention, age, and sex. In the fully model, we adjusted for cohort, intervention, age, sex, heart rate, weight, SBP, hemoglobin, TRIG, smoking or tobacco, hypertension, prior TIA or stroke, diabetes, heart failure, cardiac shock, Killip class, LVEF category.
For CV death, in the non-adjusted model, we did not adjust other covariates. In the minor-model, we adjusted for cohort, intervention, age, and sex. In the fully model, we adjusted for cohort, intervention, age, sex, weight, heart rate, troponin, TRIG, smoking or tobacco, hypertension, diabetes, heart failure, cardiac shock, Killip class, LVEF category, symptom onset to arrival.