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Association of Total Cholesterol/High-Density Lipoprotein Cholesterol Ratio With Proximal Coronary Atherosclerosis Detected by Multislice Computed Tomography
Authors:Deepu Nair,MD,   Thomas P. Carrigan,MD,   Ronan J. Curtin,MD,   Zoran B. Popovic,MD,PhD,   Stacie Kuzmiak,RT,   Paul Schoenhagen,MD,   Scott D. Flamm,MD,   Milind Y. Desai,MD
Affiliation:From the Cardiovascular Imaging Laboratory, Heart and Vascular Institute;;and Imaging Institute, Cleveland Clinic, Cleveland, OH
Abstract:The authors assessed the association between an elevated total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) ratio (≥4) and proximal coronary artery disease (CAD), as observed on multislice computed tomography. Coronary multislice computed tomographic angiography (96% on 40- or 64-slice) was performed in 295 individuals (39% women; mean age, 54±13 years) without documented CAD who were referred for coronary evaluation. Significant CAD was defined as ≥50% stenosis in the left main, proximal left anterior descending, or ≥2 epicardial vessels. Proximal plaque was defined as presence of any plaque in left main or proximal left anterior descending vessels. Individuals with an elevated TC/HDL-C ratio vs those without had a higher prevalence of proximal plaque (62% vs 48%, P =.04) and significant CAD (19% vs 9%, P =.009). On multivariate logistic regression analysis, only age, sex, and TC/HDL-C ratio ≥4 were associated with significant CAD and proximal plaque.
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