Abstract

Objective: To investigate the characteristics and determine the value of the Non-HDL-C/HDL-C ratio in predicting the extent of coronary artery disease (CAD) in patients with obstructive CAD.

Methods: A cross-sectional descriptive analytical study was conducted on 226 patients diagnosed with obstructive CAD on coronary computed tomography angiography. The extent of CAD was assessed using the Gensini score. Patients were divided into two groups based on the median Non-HDL-C/HDL-C ratio: low Non-HDL-C/HDL-C (≤ 2.71, n=133) and high Non-HDL-C/HDL-C (>2.71, n=133).

Results: The mean age of the study group was 64.7 ± 8.0 years, 69% male. The Non-HDL-C/HDL-C ratio was associated with body mass index, smoking, diabetes mellitus, dyslipidemia, total cholesterol, LDL-C, HDL-C, triglycerides, the number of CAD vessels, and the Gensini score (all p<0.05). A moderate positive correlation was found between the Non-HDL-C/HDL-C ratio and the Gensini score (r=0.387, p<0.001). ROC analysis indicated that the Non-HDL-C/HDL-C ratio predicted a high Gensini score with an AUC of 0.696 (95% CI: 0.623–0.769; p<0.001). Multivariate logistic regression analysis identified the Non-HDL-C/HDL-C ratio as an independent predictor of a high Gensini score (OR = 1.66; 95% CI: 1.11–2.50; p = 0.014).

Conclusion: The Non-HDL-C/HDL-C ratio is associated with traditional cardiovascular risk factors and the extent of coronary lesions in patients with obstructive CAD. The Non-HDL-C/HDL-C ratio is an independent predictor of severe CAD with a moderately high predictive value for early detection of patients with complex high-risk lesions, thereby allowing timely management and intervention to improve patient prognosis.