Background The TyG index is an indicator of insulin resistance (IR), which is associated with the development and prognosis of cardiovascular disease. This study aimed to summarize the relationship between the TyG index and the risk, severity, and prognosis of coronary artery disease (CAD) by performing a systematic review and meta-analysis. Methods The PubMed, EMBASE, The Cochrane Library, and Web of Science databases were searched for articles published from inception until May 1, 2023. Cross-sectional studies, retrospective or prospective cohort studies recruiting patients with CAD were included. For the analysis of CAD severity, the outcomes were coronary artery calcification, coronary artery stenosis, coronary plaque progression, multi-vessel CAD, and in-stent re-stenosis. For the analysis of CAD prognosis, the primary outcome was major adverse cardiovascular events (MACE). Results Forty-one studies were included in this study. Compared to patients with the lowest TyG index, those with the highest TyG index had a higher CAD risk [odds ratio (OR): 1.94, 95% confidence interval (CI) 1.20–3.14, I2 = 91%, P = 0.007]. Additionally, these patients were more likely to have stenotic coronary arteries (OR: 3.49, 95% CI 1.71–7.12, I2 = 0%, P = 0.0006), progressed plaques (OR: 1.67, 95% CI 1.28–2.19, I2 = 0%, P = 0.002), and with more vessels involved (OR: 2.33, 95% CI 1.59–3.42, I2 = 0%, P < 0.0001). When calculated as a categorized variable, it appears that acute coronary syndrome (ACS) patients with higher TyG index levels may have a higher incidence rate of MACE [hazard ratio (HR): 2.09, 95% CI 1.68–2.62, I2 = 87%, P < 0.00001], whereas chronic coronary syndrome (CCS) or stable CAD patients with higher TyG index levels showed a trend towards an increased incidence rate of MACE (HR: 1.24, 95% CI 0.96–1.60, I2 = 85%, P = 0.09). When calculated as a continuous variable, ACS patients had an HR of 2.28 per 1-unit/1-standard deviation increment of the TyG index (95% CI 1.44–3.63, I2 = 95%, P = 0.0005). Similarly, CCS or stable CAD patients had an HR of 1.49 per 1-unit/1-standard deviation increment of the TyG index (95% CI 1.21–1.83, I2 = 75%, P = 0.0001). Myocardial infarction with non-obstructive coronary arteries patients had an HR of 1.85 per 1-unit increment of the TyG index (95% CI 1.17–2.93, P = 0.008). Conclusions The TyG index is a simple new synthetic index that has been proven to be a valuable tool in the whole-course management of CAD patients. Patients with higher TyG index levels are at a higher risk of CAD, more severe coronary artery lesions, and worse prognosis compared to those with lower TyG index levels.

Background Cancer therapy‐related cardiovascular toxicity (CTR‐CVT) is a major contributor to poor prognosis in breast cancer (BC) patients undergoing chemotherapy. Left ventricular global longitudinal strain (LV GLS) has predictive value for CTR‐CVT, while few researchers take into account late‐onset CTR‐CVT. This study sought to provide a guide for the prediction of late‐onset CTR‐CVT in primary BC over the 2 years follow‐up via strain and contrast‐enhanced echocardiography. Methods Anthracycline and anthracycline + targeted medication groups were created from 111 patients with stage I–III primary BC who were prospectively included. The left ventricular diastolic function, LV global long‐axis strain (GLS); left ventricular ejection fraction by contrast‐enhanced echocardiography (c‐LVEF), and electrocardiograms were collected at baseline, 3, 6, 12, and 24 months after the start of cancer treatment. The high‐sensitivity troponin‐T and NT‐pro BNP at baseline and 3 months after chemotherapy were measured. Results (1) LV GLS decreased in BC patients over time. (2) After 12 months' follow‐up, the LV GLS in the anthracycline+ targeted group was lower than in the anthracycline group. After 24 months' follow‐up, the GLS and c‐LVEF in the anthracycline + targeted group declined while the E/e’ increased. (3) Decreased LVEF (56%) and arrhythmia (38%) are the common causes of CTR‐CVT. Lower LVEF was a major factor in late‐onset CTR‐CVT. (4) Combination of LV GLS and c‐LVEF at 3 months were used as predictors for CTR‐CVT and exhibited a higher AUC than either one alone (AUC = 0.929, 95% CI: 0.863–0.970). LV GLS at 3 months can predict the late‐onset CTR‐CVT (AUC = 0.745, p < 0.001), and the cut‐off is 20.32%. Conclusions As time went on, the systolic and diastolic dysfunction of BC patients get worsened. The combination of LV GLS and c‐LVEF is better in the prediction of CTR‐CVT. Only the LV GLS at 3 months can predict the late‐onset CTR‐CVT.

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Takayasu’s arteritis (TAK) is a rare chronic granulomatous arteritis that mainly affects the aorta and its major branches. Coronary artery (CA) involvement can be observed in 10–25% of TAK patients. We report a 21-year-old young female who was previously diagnosed with TAK and severe left main coronary artery (LMCA) stenosis and underwent numerous percutaneous coronary interventions (PCIs) in our hospital due to in-stent restenosis (ISR). This time, an excimer laser coronary atherectomy (ELCA) and drug-coated balloon (DCB) dilation was taken at the LMCA for the ISR. The blood flow was smooth after the operation, and she was symptom-free after discharge. Unfortunately, 5 months later, severe intimal hyperplasia was still seen in the stent of LMCA and left anterior descending (LAD) coronary artery. A coronary artery bypass graft surgery (CABG) was performed, and she has been symptom-free ever since. ELCA plus DCB is one of the novel ways we first reported. However, ensuring long-term inflammation control is equally important to restore blood flow. The combination of revascularization and anti-inflammation/immunosuppression is recommended to improve the outcomes of TAK patients with CA involvements.

Cardiac amyloidosis (CA) occurs when the insoluble fibrils formed by misfolded precursor proteins deposit in cardiac tissues. The early clinical manifestations of CA are not evident, but it is easy to progress to refractory heart failure with an inferior prognosis. Echocardiography is the most commonly adopted non-invasive modality of imaging to visualize cardiac structures and functions, and the preferred modality in the evaluation of patients with cardiac symptoms and suspected CA, which plays a vital role in the diagnosis, prognosis, and long-term management of CA. The present review summarizes the echocardiographic manifestations of CA, new echocardiographic techniques, and the application of multi-parametric echocardiographic models in CA diagnosis.