Frontiers in cardiovascular medicine · 2026
Triglyceride levels and all-cause mortality in patients with left main coronary artery disease undergoing percutaneous coronary intervention.
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Lu HongJing, Yan Yufeng, Xu Haimei, Zhao Yingying, Lin Song, Zheng Yaguo
Аннотация
BACKGROUNDS: Triglycerides (TG) and triglyceride-rich lipoproteins contribute to the development and progression of atherosclerosis. However, the prognostic value of TG levels in patients with left main coronary artery disease (LMCAD) remains unexplored. This study aimed to examine the association between TG levels and long-term mortality within this population.
METHODS: We conducted a single-center retrospective study of 2,778 patients with LMCAD undergoing percutaneous coronary intervention (PCI). We modeled the association between TG levels and the hazard ratio (HR) for mortality using restricted cubic splines (RCS). An optimal TG cutoff for stratification was identified using the maximum selected rank statistic, and patients were then divided into two groups. We assessed the proportional hazards assumption with plots of Schoenfeld residuals. The primary endpoint was all-cause death. Secondary endpoints included cardiovascular death, myocardial infarction, stroke, stent thrombosis, and target vessel revascularization.
RESULTS: Over a mean follow-up of 47.4 ± 30.3 months, 351 (12.6%) patients died, including 207 cardiovascular deaths. Restricted cubic spline analysis showed a linear inverse relationship between TG levels and all-cause mortality. An optimal TG cutoff of 0.93 mmol/L was identified, dividing patients into high-TG (n = 2214) and low-TG (n = 564) groups. The low-TG group had significantly higher all-cause mortality (17.2% vs. 11.5%, log-rank P<0.001). After multivariable adjustment, low TG remained independently associated with a higher risk of all-cause mortality [adjusted HR: 1.379; 95% confidence interval (CI): 1.069-1.778; P = 0.013]. The low-TG group was also associated with a higher risk of cardiovascular mortality (9.4% vs. 7.0%, log-rank P = 0.011). No significant associations were observed between TG levels and other secondary endpoints. Subgroup analyses confirmed the consistent prognostic value of TG across clinical subgroups.
CONCLUSION: Our findings indicate that low TG levels are an independent prognostic factor for all-cause mortality among LMCAD patients undergoing PCI.
METHODS: We conducted a single-center retrospective study of 2,778 patients with LMCAD undergoing percutaneous coronary intervention (PCI). We modeled the association between TG levels and the hazard ratio (HR) for mortality using restricted cubic splines (RCS). An optimal TG cutoff for stratification was identified using the maximum selected rank statistic, and patients were then divided into two groups. We assessed the proportional hazards assumption with plots of Schoenfeld residuals. The primary endpoint was all-cause death. Secondary endpoints included cardiovascular death, myocardial infarction, stroke, stent thrombosis, and target vessel revascularization.
RESULTS: Over a mean follow-up of 47.4 ± 30.3 months, 351 (12.6%) patients died, including 207 cardiovascular deaths. Restricted cubic spline analysis showed a linear inverse relationship between TG levels and all-cause mortality. An optimal TG cutoff of 0.93 mmol/L was identified, dividing patients into high-TG (n = 2214) and low-TG (n = 564) groups. The low-TG group had significantly higher all-cause mortality (17.2% vs. 11.5%, log-rank P<0.001). After multivariable adjustment, low TG remained independently associated with a higher risk of all-cause mortality [adjusted HR: 1.379; 95% confidence interval (CI): 1.069-1.778; P = 0.013]. The low-TG group was also associated with a higher risk of cardiovascular mortality (9.4% vs. 7.0%, log-rank P = 0.011). No significant associations were observed between TG levels and other secondary endpoints. Subgroup analyses confirmed the consistent prognostic value of TG across clinical subgroups.
CONCLUSION: Our findings indicate that low TG levels are an independent prognostic factor for all-cause mortality among LMCAD patients undergoing PCI.