Association between the triglyceride–glucose index and severity of coronary artery disease

Abstract

Background The triglyceride–glucose (TyG) index, which is a reliable surrogate marker of insulin resistance (IR), has been associated with cardiovascular diseases. However, evidence of the impact of the TyG index on the severity of coronary artery disease (CAD) is limited. This study investigated the relationship between the TyG index and CAD severity of individuals with different glucose metabolic statuses. Methods This study enrolled 2792 participants with CAD in China between January 1, 2018 and December 31, 2021. All participants were divided into groups according to the tertiles of the TyG index as follows: T1 group, TyG index < 6.87; T2 group, TyG index ≥ 6.87 to < 7.38; and T3 group, TyG index ≥ 7.38. The glucose metabolic status was classified as normal glucose regulation, pre-diabetes mellitus (pre-DM), and diabetes mellitus according to the standards of the American Diabetes Association. CAD severity was determined by the number of stenotic vessels (single-vessel CAD versus multi-vessel CAD). Results We observed a significant relationship between the TyG index and incidence of multi-vessel CAD. After adjusting for sex, age, body mass index, smoking habits, alcohol consumption, hypertension, estimated glomerular filtration rate, antiplatelet drug use, antilipidemic drug use, and antihypertensive drug use in the logistic regression model, the TyG index was still an independent risk factor for multi-vessel CAD. Additionally, the highest tertile of the TyG group (T3 group) was correlated with a 1.496-fold risk of multi-vessel CAD compared with the lowest tertile of the TyG group (T1 group) (odds ratio [OR], 1.496; 95% confidence interval [CI], 1.183–1.893; P < 0.001) in the multivariable logistic regression model. Furthermore, a dose–response relationship was observed between the TyG index and CAD severity (non-linear P = 0.314). In the subgroup analysis of different glucose metabolic statuses, the T3 group (OR, 1.541; 95% CI 1.013–2.344; P = 0.043) were associated with a significantly higher risk of multi-vessel CAD in individuals with pre-DM. Conclusions An increased TyG index was associated with a higher risk of multi-vessel CAD. Our study indicated that TyG as an estimation index for evaluating IR could be a valuable predictor of CAD severity, especially for individuals with pre-DM.

Independent effects of the triglyceride-glucose index on all-cause mortality in critically ill patients with coronary heart disease: analysis of the MIMIC-III database

“…Moreover, multi-vessel coronary artery disease is a type of CHD with a high risk of adverse events [5]. An elevated TyG index is associated with a significantly higher risk of multi-vessel coronary artery disease [10]. However, whether this association exists in critically ill patients with CHD, who have more severe pathophysiological conditions, remains unclear.…”

Non-insulin-based insulin resistance indexes in predicting severity for coronary artery disease

“…Results from a large-scale retrospective analysis conducted in South Korea revealed that the group with the highest TyG index had a higher risk of stroke and myocardial infarction [ 31 ]. On the other hand, Su et al [ 13 ] demonstrated that TyG index was associated with CAD severity, while Wang et al [ 2 ] showed that TyG index, as an indicator for evaluating IR, may be a valuable predictor of CAD severity. Our results were consistent with findings from the above-mentioned studies.…”

“…Previous studies have shown that drug interventions, such as hypoglycemic agents, antiplatelet drugs, lipid-lowering drugs and antihypertensive drugs, may affect the results [ 39 , 40 ]. However, some studies also revealed that TyG index and METS-IR were still predictors of CAD after adjusting for the effect of drugs [ 2 , 13 , 14 ]. Medication history was not included in our study due to lack of detailed data.…”

“…Coronary artery disease (CAD) causes a huge health and economic burden on medical systems around the world, with a high risk of death [ 1 ], a phenomenon that negatively impacts families. In recent years, the discovery and prevention of coronary heart disease (CHD) risk factors has significantly reduced prevalence and mortality of CHD, but the number of with CHD patients is still relatively high [ 2 ]. Therefore, more sensitive and easier predictors need to be sought to identify the severity of CAD in advance and to accurately formulate early intervention strategies.…”

“…Consequently, researchers have adopted triglyceride and glucose (TyG) index [ 8 ], triglyceride glucose-body mass (TyG-BMI) index [ 9 ], triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio [ 10 , 11 ], and metabolic score for insulin resistance (METS-IR) [ 12 ] as simple and reliable substitutes for IR. Previous studies have shown that TyG index, TG/HDL-C ratio and METS-IR are related to the severity of coronary lesions in CAD patient [ 2 , 13 , 14 ], with limited evidence. Further, TyG-BMI index was associated with increased risk of cardiovascular disease (CVD) and stroke [ 15 – 17 ], to date, however, nothing is known regarding the relationship between TyG-BMI index and CAD severity.…”