Relationship between TyG index and the degree of coronary artery lesions in patients with H-type hypertension

Abstract

Background The TyG index, a prominent metric for assessing insulin resistance, has gained traction as a prognostic tool for cardiovascular disease. Nevertheless, the understanding of the prognostic significance of the extent of coronary artery stenosis in individuals afflicted with H-type hypertension remains limited. Methods A retrospective study was conducted at Wuhan Third Hospital, including a cohort of 320 inpatients who were diagnosed with hypertension in combination with coronary artery disease. The study period spanned from January 1, 2021, to February 1, 2023. The study cohort was stratified based on the severity of stenosis into three distinct groups: low stenosis, medium stenosis, and high stenosis, as determined by the Gensini score derived from coronary angiography findings. The present study aimed to investigate the association between the severity of coronary stenosis and the number of lesion branches, utilizing the TyG index as a testing indicator. The predictive ability of TyG for coronary lesion severity was assessed using logistic regression analysis. Results The results of our study indicate a positive correlation between elevated levels of TyG and an increased susceptibility to severe stenosis in individuals diagnosed with H-type hypertension. Upon careful consideration of potential confounding variables, it has been observed that the TyG index exhibits a robust association with the likelihood of severe stenosis in individuals with H-type hypertension (odds ratio [OR] = 4000, 95% confidence interval CI 2.411–6.635, p = 0.0001), as well as the prevalence of multivessel disease (OR = 1.862, 95% CI 1.036–3.348, p < 0.0001). The TyG index demonstrated superior predictive ability for severe coronary stenosis in patients with H-type hypertension compared to those without H-type hypertension (area under the curve [AUC] = 0.888, 95% confidence interval CI 0.838–0.939, p < 0.0001, versus AUC = 0.615, 95% CI 0.494–0.737, p < 0.05). Conclusion The TyG index is an independent risk factor for the degree of coronary stenosis and a better predictor in patients with H-type hypertension combined with coronary artery disease.

Prediabetes Increases the Risk of Frailty in Prefrail Older Adults With Hypertension: Beneficial Effects of Metformin

“…Various studies have validated its diagnostic accuracy compared with hyper-insulinemic-euglycemic clamp and homeostasis model assessment of insulin resistance, achieving high sensitivity (up to 96% with hyper-insulinemic-euglycemic clamp) and specificity (up to 99% with homeostasis model assessment of insulin resistance). 20,[57][58][59][60][61][62][63][64] The TyG index has demonstrated effectiveness in estimating insulin resistance in individuals with and without diabetes, regardless of insulin treatment status, as it does not require insulin quantification; besides, it has been linked to increased risks of mortality and various cardiovascular diseases, including carotid atherosclerosis, coronary artery disease, metabolic syndrome, and type 2 diabetes. [65][66][67][68] It is noteworthy that an established drug such as metformin has shown promise in reversing frailty in this population, likely through its antiaging effects.…”