Association of the triglyceride–glucose index with coronary artery disease complexity in patients with acute coronary syndrome

Abstract

Aim The triglyceride–glucose (TyG) index has been shown to be an independent predictor for the progression and prognosis of coronary artery disease (CAD). Whether the TyG index predicts the severity of CAD in patients presenting with acute coronary syndrome (ACS) remains unknown. Methods A total of 1,007 individuals presenting with ACS undergoing coronary angiography were stratified according to the tertiles of the TyG index and The Synergy Between Percutaneous Coronary Intervention (SYNTAX) score (SYNTAX score ≤ 22 versus SYNTAX score > 22). CAD complexity was determined by the SYNTAX score. Results After adjusting for multiple confounding factors, the TyG index was still an independent risk factor for mid/high SYNTAX scores (SYNTAX score > 22, OR 2.6452, 95% CI 1.9020–3.6786, P < 0.0001). Compared with the lowest tertile of the TyG (T1) group, the risk for a mid/high SYNTAX score in the T2 and T3 groups was 2.574-fold higher (OR, 2.574; 95% CI 1.610–4.112; P < 0.001) and 3.732-fold higher (OR, 3.732; 95% CI 2.330–5.975; P < 0.001), respectively. Furthermore, there was a dose‒response relationship between the TyG index and the risk of complicated CAD (SYNTAX score > 22; nonlinear P = 0.200). The risk for a mid/high SYNTAX score in the T2 and T3 groups was significantly higher in normoglycemia, prediabetes mellitus, and diabetes mellitus subgroups. Conclusions A higher TyG index was associated with the presence of a higher coronary anatomical complexity (SYNTAX score > 22) in ACS patients, irrespective of diabetes mellitus status. The TyG index might serve as a noninvasive predictor of CAD complexity in ACS patients and could potentially influence the management and therapeutic approach.

Triglyceride-glucose index is associated with recurrent revascularization in patients with type 2 diabetes mellitus after percutaneous coronary intervention

“…Furthermore, dyslipidemia resulting from insulin resistance, characterized by increased plasma triglyceride levels, decreased levels of high-density lipoprotein (HDL), and the presence of small dense low-density lipoproteins (sdLDL) [23][24][25], also contributes to the formation of atherosclerotic plaques [8]. Consequently, the TyG index, considered as an affordable, practical, and reproducible surrogate marker of insulin resistance in comparison to the hyperinsulinemic-euglycemic clamp test and HOMA-IR [10], has shown associations with the complexity of coronary artery lesions in several observational clinical studies [26,27].…”

Association of the triglyceride glucose index with all-cause and cardiovascular mortality in a general population of Iranian adults

“…A series of recent studies have indicated that elevated TyG index is linked to a higher risk of CVD [ 7 ], CAD [ 8 ], PAD [ 9 ], and stroke [ 10 ]. Nevertheless, the relationship between TyG index and CVD mortality (CVM) and all-cause mortality (ACM) is still obscure.…”

“…Low- and middle- income countries (LMIC) has experienced a remarkable rise in the frequency of CVD and CVM in recent decades [ 12 ]. Eighty percent of CVM cases in recent years have been reported in LMIC, particularly in Middle Eastern countries [ 7 , 8 ]. Furthermore, studies have demonstrated that Iranians exhibit a greater prevalence of risk factors for CVD, central obesity [ 13 ], metabolic syndrome [ 14 ], and diabetes mellitus (DM) [ 15 ] when compared to the general population of other countries[ 16 , 17 ] that indicate impaired metabolism and hyperinsulinemia [ 18 , 19 ].…”

Association of the triglyceride-glucose index with severity of coronary stenosis and in-hospital mortality in patients with acute ST elevation myocardial infarction after percutaneous coronary intervention: a multicentre retrospective analysis cohort study

“… 7–9 Recently, several studies have indicated that the TyG index may be an effective indicator of the complexity and severity of CAD. 10 11 The relationship between the TyG index and the degree of coronary stenosis in individuals with acute ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) remains, however, poorly known. Furthermore, the studies regarding the influences of the TyG index on the poor prognosis in patients suffering from STEMI are extremely limited.…”