Triglyceride-rich Lipoprotein Cholesterol, Lipid Profiles, and Inhospital Outcomes in Acute Myocardial Infarction: A Comparison of ST-segment Elevation Myocardial Infarction and Non-ST-segment Elevation Myocardial Infarction Patients

INTRODUCTION: Triglyceride-rich lipoprotein cholesterol (TRL-C) appears as an emerging atherosclerotic risk factor. However, the comparative evidence between ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) is limited, especially in Indian population. The aim of the study is to assess the TRL-C level, lipid profile, and inhospitalization outcome. METHODS: This hospital-based cross-sectional study included 125 myocardial infarction (MI) patients at a tertiary care hospital in Pune. The lipid profile test was performed in fasting conditions of patients, and estimation of TRL-C was done by subtracting the low-density lipoprotein cholesterol (LDK-C) and high-density lipoprotein cholesterol (HDL-C) from total cholesterol. The parameters such as clinical, cardiac biomarkers, electrocardiograph (ECG) results, and inhospitalization outcomes were reported. The statistical analysis was done in RStudio (version 2025.05.1). RESULTS: The baseline demographic features or characteristics and cardiovascular-related risk factors were found comparable in both groups. The TRL-C level was found to be higher in number in STEMI patients (44.84 ± 93.46) than NSTEMI patients (27.05 ± 63.82), but this difference was not statistically significant (P = 0.216). However, triglyceride (TG) levels in NSTEMI patients were significantly higher (216.43 ± 77.89) at P = 0.004; also, the TG/HDL-C ratio was found to be higher (5.43 ± 2.25 vs. 4.63 ± 2.28; P = 0.05). The level of cardiac biomarkers such as creatine phosphokinase-MB and troponin-I was found significantly higher (both P < 0.001); also, total leukocyte count (P < 0.001) and length of stay in hospital (8.44 ± 2.26 vs. 6.71 ± 2.15; P < 0.001) were higher. The mortality rate in hospital in both the groups was not significant (3.2% vs. 6.3%; P = 0.878). The smoking percentage in both the groups were nearly equal (40%). CONCLUSION: The trend was observed as higher TRL-C levels in STEMI patients may be because of interindividual variability. In NSTEMI patients, increased TGs and TG/HDL ratio are indicators of a different metabolic and atherogenic phenotype. The inclusion of TRL-C in routine lipid assessment will help identify residual cardiac disease risk in acute coronary syndrome patients.