Comparison of prognostic value between CAD-RADS 1.0 and CAD-RADS 2.0 evaluated by convolutional neural networks based CCTA

The triglyceride glucose (TyG) index has been suggested as a reliable substitute to indicate insulin resistance. Several studies have identified the association between the TyG index and cardiovascular disease. However, the association between the TyG index and the incidence of myocardial ischemia in patients with minimal to moderate coronary artery disease (CAD) has not been clearly assessed. We aimed to investigate the association between the TyG index and the incidence of myocardial ischemia in patients with minimal to moderate CAD. A total of 1,697 patients who underwent coronary computed tomography angiography (CTA) examinations and had minimal to moderate CAD were retrospectively included in the study. The TyG index and computed tomography–derived fractional flow reserve (CT-FFR) were used to assess insulin resistance (IR) and myocardial ischemia, respectively. Myocardial ischemia was defined as a CT-FFR value ≤ 0.80. Logistic regression models were used to explore the associations between the TyG index and myocardial ischemia. The incidence of myocardial ischemia was higher in the highest TyG index tertile (T3) group than in the lowest TyG index tertile (T1) group. After adjusting for other variables, the T3 group remained associated with a higher risk of myocardial ischemia than the T1 group did (OR, 1.43; 95% CI, 1.01–2.04; p = 0.047). A 1- standard deviation (SD) increase in the TyG index was correlated with a 19–24% elevated risk of myocardial ischemia when regarding the TyG index was considered as a continuous variable. Subgroup analysis revealed similar effects. A TyG index is associated with a higher risk of myocardial ischemia detected by CT-FFR in patients with minimal to moderate CAD.

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Lack of incremental prognostic value of triglyceride glucose index beyond coronary computed tomography angiography features for major events

Huang,

Tang,

Ding

et al. 2024

Sci Rep

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This study was aim to determine the prognostic value of triglyceride-glucose (TyG) index and coronary computed tomography angiography (CTA) features for major adverse cardiovascular events (MACE). In addition, we investigate the incremental prognostic value of TyG index beyond coronary CTA features in patients with suspected or known coronary artery disease (CAD). The present study ultimately includes 3528 patients who met the enrollment criteria. The TyG index was calculated based on measured levels of triglycerides and fasting blood glucose. Primary combined endpoint consisted of MACE, which defined as myocardial infraction (MI), all-cause mortality and stroke. Three multivariate Cox proportional hazard regression models were performed to assess the association between TyG index and MACE. C-statistic was performed to assess the discriminatory value of models. 212 (6.0%) patients developed MACE during a median follow-up of 50.4 months (IQR, 39.4–55.1). TyG index remained to be a significantly and independent risk factors for predicting MACE after adjusting by different models (clinical variables alone or plus coronary CTA features) in multivariable analysis. Both the addition of TyG index to clinical model plus Coronary Artery Disease Reporting and Data System (CAD-RADS) and to clinical model plus CAD-RADS 2.0 slightly but not significantly increased the C-statistic index (0.725 vs. 0.721, p = 0.223; 0.733 vs. 0.731, p = 0.505). TyG index was associated with an increased risk of MACE. However, no incremental prognostic benefit of TyG index over CAD-RADS or CAD-RADS 2.0 was detected for MACE in patients with suspected or known CAD.

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Comparison of prognostic value between CAD-RADS 1.0 and CAD-RADS 2.0 evaluated by convolutional neural networks based CCTA

Cited by 5 publications

References 38 publications

Classification CAD-RADS 2.0 : regards croisés radiologue-cardiologue sur son utilisation pratique

Classification CAD-RADS 2.0 : regards croisés radiologue-cardiologue sur son utilisation pratique

Association of the triglyceride glucose index with myocardial ischemia in patients with minimal to moderate coronary artery disease

Lack of incremental prognostic value of triglyceride glucose index beyond coronary computed tomography angiography features for major events

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