ORIGINAL ARTICLE P J M H S VOL. 7 NO.4 OCT – DEC 2013 933 Role of Triglyceride to High Density Lipoprotein Cholesterol Ratio as a Risk Factor of Coronary Artery Disease in Women TAHIRA DURRANI, MOHAMMAD AAMIR, MARIYAH HIDAYAT* ABSTRACT Aim: To assess the role of Triglyceride to High Density lipoprotein cholesterol (TG/HDL_C) ratio as a risk factor of coronary heart disease in women Study design: Cross sectional study. Place and duration of study: The study was conducted in Ayub teaching Hospital, Abbottabad, for 8months from January to August, 2010. Methods: The study was conducted in 100 females known cardiac patients and 50 controls who were referred for Exercise tolerance test (ETT) for assessment of angina. The lipid profile for total cholesterol (TC), Triglyceride (TG), high density lipoprotein cholesterol (HDL_C), Low density lipoprotein cholesterol (LDL_C) levels were determined in fasting blood samples and analyzed for correlation. Results: Lipid profile (TG, and HDL_C) of the patients were deranged. Serum Triglyceride to High density lipoprotein cholesterol (TG/HDL_C) ratio was found to be a risk factor for coronary heart disease in women. Conclusions: The results of the investigation indicated that Triglyceride to high density lipoprotein cholesterol is associated with coronary heart disease. Keywords: Coronary artery disease, cholesterol, trigliceride INTRODUCTION Coronary heart diseases (CHD) is one of the common cause of death in women, particularly in developed countries like the USA 1 .Pakistanis are part of an ethnic group that suffers from the highest prevalence rates of coronary artery disease compared to any throughout the world. CAD manifests at a younger age with a significant narrowing of the sex difference 2 . There is significant increase in the frequency of CAD in the local population, more so in the female population with a similar mortality over a decade 3 . Various risk factors have been identified, of which the important modifiable risk factors include diabetes mellitus, hypertension obesity and elevated serum cholesterol 4 . Several studies have been carried out in Pakistan which show that the probability of CHD increases continuously due to different risk factors. In postmenopausal women decrease in estradiol level and associated decrease in HDL-C have been observed and may be responsible for the increased risk of coronary heart disease after menopause 5 . A low level of high density lipoprotein cholesterol ----------------------------------------------------------------------- Department of Biochemistry, Women Medical College, Abbottabad, *Assistant Professor Anatomy Department, Rahbar Medical College, Lahore. Correspondence to Dr. Mohammad Aamir, House 18, Bilal Colony, Mirpur, Mansehra Road, Abbottabad. Email doctoraamir@gmail.com Cell: 0300 9110779 (HDL-C) is important in coronary heart disease development and has been widely accepted, whereas the role of hypertriglyceridemia remains controversial. Recent analysis shows that hypertriglyceridemia is an independent predictor of Coronary heart disease and it can be a stronger risk factor among women then among men 6,7 . Limited data is available on prognostic utility of the TG/HDL-C ratio. Gaziano et al. 8 were the first to conduct a case control study and reported that, this ratio strongly predicts risk of Myocardial infarction in both sexes. The importance of abnormal TG/HDL-C ratios is highlighted further by the first ever study on TG/HDL-C related mortality published in August 2009, where the authors have shown that the TG/HDL-C ratio is a risk factor for mortality in women with suspected myocardial ischemia 9 . Despite these studies globally, no studies on the TG/HDL-C ratio in predicting worse outcome in women have been carried out, although women represent a significant number of patients suffering from CHD. The present study is carried out to determine whether TG/HDL-C ratio is a predictor of CHD in women. PATIENTS AND METHODS The study was conducted in the CCU and Cardiology OPD of Ayub Teaching Hospital for 8 months from January to August, 2010. Samples were collected