Correlation between serum low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio and clinical characteristics of patients with coronary heart disease: a cross-sectional study.

Background: The low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio is a critical indicator of lipid metabolism homeostasis and significantly influences vascular health. However, its correlation with clinical characteristics in patients with coronary heart disease (CHD) remains insufficiently elucidated. This study investigates the association between the LDL-C/HDL-C ratio and clinical characteristics in CHD patients and evaluates its potential to predict the risk of progression from angina pectoris to myocardial infarction (MI). Methods: This cross-sectional study initially enrolled 7,931 hospitalized patients from Jiangsu Provincial People's Hospital and Wuxi Second People's Hospital between September 2018 and September 2021. After excluding patients with missing data, malignancies, immune system disorders, hematologic diseases, cardiomyopathies, or severe infections, 3,707 patients who met the inclusion and exclusion criteria were included. Serum levels of LDL-C, HDL-C, and LDL-C/HDL-C ratio were measured upon admission. Participants were stratified into quartiles based on LDL-C/HDL-C ratio and clinical subtypes. Multivariate logistic regression analysis evaluated the relationship between LDL-C/HDL-C levels and clinical subtypes of CHD, and subgroup analyses assessed the association between LDL-C/HDL-C levels and clinical features in CHD patients. Results: Among CHD patients with higher LDL-C/HDL-C ratio, a greater proportion were male, smokers, or MI participants (P<0.05), with elevated levels of heart rate (HR), body mass index (BMI), LDL-C, total cholesterol (TC), triglycerides (TG), and fasting blood glucose (FBG) (P<0.05), while a lower proportion had undergone prior percutaneous coronary intervention (PCI) (P<0.05). Multivariate logistic regression analysis revealed that for each unit increase in LDL-C/HDL-C ratio, the risk of MI in CHD patients was 99% higher compared to angina patients [odds ratio (OR) =1.99; 95% confidence interval (CI): 1.50-2.63; P<0.001]. Subgroup analysis demonstrated that elevated LDL-C/HDL-C ratios were significantly associated with the risk of MI in CHD patients across the following subgroups: age ≥65 years (OR =1.44; 95% CI: 1.23-1.70; P<0.001), male (OR =1.29; 95% CI: 1.15-1.45; P<0.001), systolic blood pressure <140 mmHg (OR =1.32; 95% CI: 1.15-1.52; P<0.001), receiving statin therapy (OR =1.29; 95% CI: 1.16-1.45; P<0.001), without prior PCI (OR =1.32; 95% CI: 1.18-1.48; P<0.001), without cerebral infarction history (OR =1.29; 95% CI: 1.15-1.44; P<0.001). Regardless of smoking status, BMI (<24 or ≥24 kg/m2), FBG levels (≥6.1 or <6.1 mmol/L), history of hypertension, or diabetes, LDL-C/HDL-C ratio remained significantly correlated with the risk of MI in CHD patients rather than angina pectoris (all P<0.05). Conclusions: Compared with patients with angina pectoris, a higher LDL/HDL ratio was associated with an increased risk of MI in patients with CHD.