Distinct triglyceride-associated lipid profiles in coronary artery ectasia and ascending thoracic aortic aneurysm: A 10-year retrospective single-center case-control study.

ObjectiveCoronary artery ectasia (CAE) and ascending thoracic aortic aneurysm (ATAA) are vascular dilative disorders with unclear lipid profiles. We compared lipid parameters among patients with CAE, ATAA, and controls, focusing on triglycerides (TG).MethodsThis retrospective single-center case-control study included 490 patients with CAE, 490 with ATAA, and 490 controls from January 2016 to December 2025. Lipid associations with CAE and ATAA were assessed using multivariable logistic regression, restricted cubic splines, and subgroup analyses.ResultsCompared with controls, CAE patients had higher TG and lower HDL-C, whereas ATAA patients had higher lp(a), lower TC, LDL-C, and HDL-C. In fully adjusted models, TG was independently associated with CAE but not ATAA. Each 1-SD increase in TG was associated with higher odds of CAE (OR=1.63, 95% CI: 1.34-1.91), with a graded increase across TG quartiles (p for trend <0.001) and a non-linear dose-response pattern.ConclusionsCAE and ATAA show distinct lipid profiles. Elevated TG is independently associated with CAE, but not consistently with ATAA, suggesting different triglyceride-related metabolic patterns in coronary and aortic dilative disorders.