Triglyceride-rich Lipoprotein Cholesterol, Lipid Profiles, and Inhospital Outcomes in Acute Myocardial Infarction: A Comparison of ST-segment Elevation Myocardial Infarction and Non-ST-segment Elevation Myocardial Infarction Patients.

INTRODUCTION

Triglyceride-rich lipoprotein cholesterol (TRL-C) appears as an emerging atherosclerotic risk factor. However, the comparative evidence between ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) is limited, especially in Indian population. The aim of the study is to assess the TRL-C level, lipid profile, and inhospitalization outcome.

METHODS

This hospital-based cross-sectional study included 125 myocardial infarction (MI) patients at a tertiary care hospital in Pune. The lipid profile test was performed in fasting conditions of patients, and estimation of TRL-C was done by subtracting the low-density lipoprotein cholesterol (LDK-C) and high-density lipoprotein cholesterol (HDL-C) from total cholesterol. The parameters such as clinical, cardiac biomarkers, electrocardiograph (ECG) results, and inhospitalization outcomes were reported. The statistical analysis was done in RStudio (version 2025.05.1).

RESULTS

The baseline demographic features or characteristics and cardiovascular-related risk factors were found comparable in both groups. The TRL-C level was found to be higher in number in STEMI patients (44.84 ± 93.46) than NSTEMI patients (27.05 ± 63.82), but this difference was not statistically significant (P = 0.216). However, triglyceride (TG) levels in NSTEMI patients were significantly higher (216.43 ± 77.89) at P = 0.004; also, the TG/HDL-C ratio was found to be higher (5.43 ± 2.25 vs. 4.63 ± 2.28; P = 0.05). The level of cardiac biomarkers such as creatine phosphokinase-MB and troponin-I was found significantly higher (both P < 0.001); also, total leukocyte count (P < 0.001) and length of stay in hospital (8.44 ± 2.26 vs. 6.71 ± 2.15; P < 0.001) were higher. The mortality rate in hospital in both the groups was not significant (3.2% vs. 6.3%; P = 0.878). The smoking percentage in both the groups were nearly equal (40%).

CONCLUSION

The trend was observed as higher TRL-C levels in STEMI patients may be because of interindividual variability. In NSTEMI patients, increased TGs and TG/HDL ratio are indicators of a different metabolic and atherogenic phenotype. The inclusion of TRL-C in routine lipid assessment will help identify residual cardiac disease risk in acute coronary syndrome patients.