Background The triglyceride-glucose (TyG) index, a reliable surrogate indicator of insulin resistance, is independently associated with coronary artery disease of various clinical manifestations. This study aimed to investigate the prognostic value of the TyG index in predicting repeat revascularization and in-stent restenosis (ISR) in chronic coronary syndrome (CCS) patients undergoing percutaneous coronary intervention (PCI). Methods A total of 1414 participants were enrolled and divided into groups according to the tertiles of the TyG index. The primary endpoint was a composite of PCI complications, including repeat revascularization and ISR. The associations between the TyG index and the primary endpoint were assessed by multivariable Cox proportional hazards regression analysis with restricted cubic splines (RCS). The TyG index was calculated as Ln (fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2). Results Over a median follow-up of 60 months, 548 (38.76%) patients had experienced at least one primary endpoint event. The follow-up incidence of the primary endpoint increased with the TyG index tertiles. After adjusting for potential confounders, the TyG index was independently associated with the primary endpoint in CCS patients (HR, 1.191; 95% CI 1.038–1.367; P = 0.013). Additionally, the highest tertile of the TyG group was correlated with a 1.319-fold risk of the primary endpoint compared with the lowest tertile of the TyG group (HR, 1.319; 95% CI 1.063–1.637; P = 0.012). Furthermore, a linear and dose–response relationship was observed between the TyG index and the primary endpoint (non-linear P = 0.373, P overall = 0.035). Conclusions An increased TyG index was associated with elevated risk for long-term PCI complications, including repeat revascularization and ISR. Our study suggested that the TyG index could be a potent predictor in evaluating the prognosis of CCS patients undergoing PCI.

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Coronary artery disease (CAD) is the leading cause of death worldwide. Inflammation and atherosclerotic plaques are the primary pathological mechanisms of CAD. Upon stimulation by deposited lipids and damaged endothelium, innate and adaptive immune cells are activated and recruited to initiate plaque development. Therefore, inflammatory cells and mediators are used to identify inflammatory risk in CAD patients. HDL-cholesterol (HDL-C) is demonstrated to have anti-inflammatory roles in atherosclerosis by interfering with plasma membrane lipid rafts of immune cells. Based on this, novel inflammatory parameters such as monocyte to HDL-C ratio are explored to improve the risk estimation of CAD prognosis. Moreover, with the advance in treatment strategies targeting the inflammatory process in atherosclerosis, identifying CAD patients with increased inflammatory risk by novel inflammatory parameters is of great importance in guiding CAD management.Therefore, this review aims to summarize the current information regarding inflammatory activation and HDL-C in atherosclerosis with a particular focus on the clinical implication of the novel HDL-C-related inflammatory parameters in CAD.

Background Integrative Chinese and Western Medicine (ICWM) is widely used in coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI) in China. However, the evidence-based on the long-term prognosis and large sample on this topic are weak. The purpose of this study is to evaluate the correlation between the therapeutic effect of ICWM and the prognosis of patients after PCI.Methods This study is a prospective observational real-world cohort study that was conducted from September 2016 to August 2019 in Fuwai Hospital. The study was reviewed and approved by the Ethics Review Committee of Fuwai Hospital, Chinese Academy of Medical Sciences. We consecutively screened 6000 patients after PCI and they were followed up for 2 years. ICWM were related to prognostic outcomes using unadjusted (Kaplan-Meier curves) and risk-adjusted (multivariable Cox regression) analyses. The primary endpoint was a composite of all-cause death, revascularization, and myocardial infarction.Results A total of 5942 patients after PCI were enrolled in this study, 5453 patients were included in the final analysis (4189[76.8%] were male; mean [SD] age, 61.91[9.91] years). There were 2932 patients (53.8%) in western medicine group (WMG) and 2521 patients (46.2%) in integrated medicine group (IMG). Cox regression analysis showed that IMG had a 27% lower cumulative risk of the major adverse cardiovascular event (MACE) than WMG (hazard ratio [HR], 0.73; 95% CI, 0.63-0.85; P＜0.0001), especially in all-cause mortality and revascularization.Conclusions Among patients after PCI, ICWM compared with conventional western medicine was correlated with a lower risk of 2-year MACE. Further research is needed to provide higher levels of evidence.