Evaluating the use of novel atherogenicity indices and insulin resistance surrogate markers in predicting the risk of coronary artery disease: a case‒control investigation with comparison to traditional biomarkers

Abstract

Background Due to the contribution of coronary artery disease (CAD) to serious cardiovascular events, determining biomarkers that could robustly predict its risk would be of utmost importance. Thus, this research was designed to assess the value of traditional cardio-metabolic indices, and more novel atherogenicity indices and insulin resistance surrogate markers in the identification of individuals at risk of CAD. Methods A case‒control survey was conducted, in which 3085 individuals were enrolled. Their clinical and biochemical data were gathered at baseline. The investigated indices included the atherogenic index of plasma (AIP), triglyceride-glucose (TyG) index, TyG-body mass index (TyG-BMI), lipoprotein combine index (LCI), cholesterol index (CHOLINDEX), Castelli’s risk indices-I, II (CRI-I, CRI-II), and metabolic score for insulin resistance (METS − IR). To examine the relationship between these variables and CAD risk, multiple regression analyses adjusted for potential confounders were conducted. Results Overall, 774 angiographically confirmed CAD patients (mean age = 54 years) were compared with 3085 controls (mean age = 51 years). Higher triglyceride, total cholesterol and fasting blood sugar levels and lower HDL-C levels were related to an elevated risk of CAD (P-for-trend < 0.001), while the direct association between increased serum LDL-C concentrations and a greater risk of CAD only became apparent when excluding those with diabetes, and statin users. Among novel indices, greater values of the majority of these markers, including AIP, CRI-I, and -II, CHOLINDEX, LCI, and TyG-index, in comparison to the lower values, significantly elevated CAD risk (P-for-trend < 0.001). Conclusion According to the current findings, novel atherogenicity indices and insulin resistance surrogate markers, in particular, AIP, CRI-I and II, CHOLINDEX, LCI, and TyG-index, may be useful in predicting CAD risk.

Association of Systemic Immune Inflammation Index with Estimated Pulse Wave Velocity, Atherogenic Index of Plasma, Triglyceride-Glucose Index, and Cardiovascular Disease: A Large Cross-Sectional Study

“…Nevertheless, Spetko et al found in a cross-sectional study that higher levels of ePWV as an indicator of arterial stiffness were associated with poorer left ventricular diastolic function [41]. In a casecontrol study, AIP and TyG index helped to predict CVD risk compared to traditional measures [42]. Karadeniz et al also found that a higher TyG index was strongly 9 Mediators of Inflammation associated with major cardiovascular adverse events [43].…”

Association between nontraditional lipid parameters and cardiovascular outcomes in patients undergoing percutaneous coronary intervention: a retrospective study

“…The Castelli Risk Index (CRI-I and CRI-II) provides more comprehensive cholesterol metabolism information by incorporating cholesterol levels. An observational study found a signi cant association, indicating a 1.5fold increase in CAD risk with higher CRI, and a notable 2% increase in CAD risk with elevated LCI levels (19). Furthermore, in a study conducted by Li et al, a signi cant correlation was observed between LCI, CRI, and the severity of coronary artery disease (20).…”

Which Surrogate Insulin Resistance Indices Best Predict Coronary artery disease? a machine learning approach

“…However, the reliance on self-reported outcomes in NHANES study raises concerns about misclassi cation. Furthermore, research by Mahdavi-Roshan et al in Iran, employing a case-control approach, indicated that the TyG-index was more closely associated with CAD risk than either the METS-IR or TyG-BMI [23]. It is crucial to be cautious when interpreting these results because of inherent biases, differing ndings among various studies, dependence on cross-sectional data, and reliance on traditional statistical methods.…”

“…The ratio of triglycerides to high-density lipoprotein cholesterol (TG/HDL-C), triglyceride-glucose index (TyG index), TyGindex with body mass index (TyG-BMI), TyG index with waist circumference (TyG-WC), and metabolic score for insulin resistance (METS-IR), are the most common of these less complicated and practical markers [19,20]. Although prior studies have shown associations between these indices and CAD, there is no speci c threshold for utilizing these indices, and it remains uncertain which one of them better predicts CAD [21][22][23].…”