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. 2023 May 13;22(1):113.
doi: 10.1186/s12933-023-01846-z.

Association between the triglyceride-glucose index and the presence and prognosis of coronary microvascular dysfunction in patients with chronic coronary syndrome

Wen Zhang #  1 , Lu Liu #  1 , Huiying Chen  1 , Siqi Li  1 , Minying Wan  2 , Abdul-Quddus Mohammed  1 , Bin Xu  1 , Guoqing Yin  1 , Xian Lv  1 , Tingting Shi  1 , Jassur Galip  1 , Ayman A Mohammed  1 , Redhwan M Mareai  1 , Yawei Xu  1 , Fuad A Abdu  3 , Wenliang Che  4   5
Affiliations

Association between the triglyceride-glucose index and the presence and prognosis of coronary microvascular dysfunction in patients with chronic coronary syndrome

Wen Zhang et al. Cardiovasc Diabetol. .

Abstract

Background: Coronary microvascular dysfunction (CMD) is a strong determinant of prognosis in patients with chronic coronary syndrome (CCS). The triglyceride-glucose index (TyG index), an alternative method to evaluate insulin resistance, is positively correlated with the incidence and adverse outcomes of cardiovascular diseases. However, the relationship between the TyG index and the presence and prognosis of CMD in CCS patients has not been investigated. Therefore, we aimed to evaluate the association between the TyG index and the presence and clinical outcomes of CMD among CCS patients.

Methods: CCS patients who underwent coronary angiography between June 2015 to June 2019 were included. The TyG index was calculated as Ln[fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. Coronary angiography‑derived index of microvascular resistance (caIMR) was used to measure microvascular function, and CMD was defined as caIMR ≥ 25U. Patients with CMD were divided into three groups (T1, T2, and T3 groups) according to TyG tertiles. The primary endpoint was major adverse cardiac event (MACE).

Results: Of 430 CCS patients, 221 patients had CMD. CMD patients had significantly higher TyG index than those without CMD. Sixty-three MACE was recorded during the follow-up duration among CMD patients, and the incidence rate of MACE was higher in the T3 group compared to T1/T2 groups (39.2% vs. 20.5% vs. 25.7%; P = 0.035). Multivariable logistic regression analysis showed that the TyG index was an independent predictor of CMD (OR, 1.436; 95% CI, 1.014-2.034; P = 0.042). Compared to the T1 group, the T3 group strongly correlated with the risk of MACE in CMD patients even after adjusting for additional confounding risk factors (HR, 2.132; 95%CI, 1.066-4.261; P = 0.032).

Conclusion: TyG index is significantly associated with the risk of CMD, and it is an independent predictor of MACE among CMD patients with CCS. This study suggests that the TyG index has important clinical significance for the early prevention and risk stratification of CMD.

Keywords: Chronic coronary syndrome; Clinical outcomes; Coronary angiography‑derived index of microvascular resistance; Coronary microvascular dysfunction; Triglyceride-glucose index.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow diagram of study participants. CAG coronary angiography, CCS chronic coronary syndrome, caIMR coronary angiography-derived index of microcirculatory resistance, CMD coronary microvascular dysfunction, TyG index triglyceride-glucose index.
Fig. 2
Fig. 2
The distribution of TyG index at CMD and non-CMD patients. TyG index triglyceride-glucose index, CMD coronary microvascular dysfunction.
Fig. 3
Fig. 3
Correlation between TyG index and caIMR. TyG index triglyceride-glucose index, caIMR coronary angiography-derived index of microcirculatory resistance.
Fig. 4
Fig. 4
Kaplan–Meier survival curve for MACE in CMD patients with CCS according to TyG index tertiles. MACE major adverse cardiovascular events, CMD coronary microvascular dysfunction, CCS chronic coronary syndrome, TyG index triglyceride-glucose index, T1 TyG index tertile 1, T2 TyG index tertile 2, T3 TyG index tertile 3.
See this image and copyright information in PMC

References

    1. Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41(3):407–477. doi: 10.1093/eurheartj/ehz425. - DOI - PubMed
    1. Corcoran D, Young R, Adlam D, McConnachie A, Mangion K, Ripley D, et al. Coronary microvascular dysfunction in patients with stable coronary artery disease: The CE-MARC 2 coronary physiology sub-study. Int J Cardiol. 2018;266:7–14. doi: 10.1016/j.ijcard.2018.04.061. - DOI - PMC - PubMed
    1. Del Buono MG, Montone RA, Camilli M, Carbone S, Narula J, Lavie CJ, et al. Coronary Microvascular Dysfunction Across the Spectrum of Cardiovascular Diseases: JACC State-of-the-Art Review. J Am Coll Cardiol. 2021;78(13):1352–1371. doi: 10.1016/j.jacc.2021.07.042. - DOI - PMC - PubMed
    1. Padro T, Manfrini O, Bugiardini R, Canty J, Cenko E, De Luca G, et al. ESC Working Group on Coronary Pathophysiology and Microcirculation position paper on 'coronary microvascular dysfunction in cardiovascular disease'. Cardiovasc Res. 2020;116(4):741–755. doi: 10.1093/cvr/cvaa003. - DOI - PMC - PubMed
    1. Vancheri F, Longo G, Vancheri S, Henein M. Coronary Microvascular Dysfunction. J Clin Med. 2020;9(9):2880. doi: 10.3390/jcm9092880. - DOI - PMC - PubMed

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