Objectives: Lower extremity peripheral artery disease develops mainly due to atherosclerosis and occurs as a result of the systemic atherosclerotic process. Increased triglyceride (TG) and decreased high density lipoprotein cholesterol (HDL-C) values increase atherosclerosis risk. With regard to this information, TG/HDL-C ratio is used as the atherogenic index. The aim of the present study was to evaluate the role of TG/HDL-C ratio to predict the complexity of disease in patients with peripheral artery disease.
Methods: Patients who were diagnosed with peripheral artery disease and admitted to our clinic between August 2013 and August 2019 were included in this study retrospectively. Patients were divided into two groups based on angiographic evaluations with TransAtlantic Inter-Society Consensus-II classification. Those with TASC A-B lesions were included in Group 1 and those with TASC C-D lesions constituted Group 2.
Results: The mean ages of Group 1 (n = 314) and Group 2 (n = 98) patients were 56.1 ± 9.3 and 58.4.1 ± 8.1 years, respectively. The frequency of male gender and coronary artery disease was significantly higher in Group 2 (p = 0.043, p = 0.001, respectively). In Group 2, triglyceride and TG/HDL-C ratios were significantly high, while HDL-C was significantly low (p = 0.022, p < 0.001, p = 0.010, respectively). The multivariate logistic regression analysis performed to evaluate the parameters in predicting the angiographic complexity of peripheral artery disease showed that coronary artery disease (OR: 1.009 CI 95%: 1.003-1.021 p = 0.016) and TG/HDL-C ratio (OR: 5.385 CI 95%: 2.553-9.357 p = 0.001) were independent predictors for complexity. ROC analysis revealed that the cut-off value of TG/HDL-C was 2.9 (AUC = 0.670, p < 0.001) with 75.5% sensitivity and 56.7% specificity.
Conclusions: It is possible to predict the angiographic complexity of peripheral artery disease with TG/HDL-C ratio, also known as atherogenic index, which is easily obtained by routine biochemical parameters.
Keywords: Peripheral arterial disease; TASC II classification; atherogenic index; high density lipoprotein cholesterol; triglyceride.