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. 2024 May 31;23(1):187.
doi: 10.1186/s12933-024-02230-1.

Triglyceride-glucose index is associated with myocardial ischemia and poor prognosis in patients with ischemia and no obstructive coronary artery disease

Wen Zhang #  1 , Lu Liu #  1 , Guoqing Yin #  1 , Abdul-Quddus Mohammed  1 , Lanqing Xiang  1 , Xian Lv  1 , Tingting Shi  1 , Jassur Galip  1 , Chunyue Wang  1 , Ayman A Mohammed  1 , Redhwan M Mareai  1 , Fei Yu  2 , Fuad A Abdu  3 , Wenliang Che  4   5
Affiliations

Triglyceride-glucose index is associated with myocardial ischemia and poor prognosis in patients with ischemia and no obstructive coronary artery disease

Wen Zhang et al. Cardiovasc Diabetol. .

Abstract

Background: Ischemia and no obstructive coronary artery disease (INOCA) is increasingly recognized and associated with poor outcomes. The triglyceride-glucose (TyG) index is a reliable alternative measure of insulin resistance significantly linked to cardiovascular disease and adverse prognosis. We investigated the association between the TyG index and myocardial ischemia and the prognosis in INOCA patients.

Methods: INOCA patients who underwent both coronary angiography and myocardial perfusion imaging (MPI) were included consecutively. All participants were divided into three groups according to TyG tertiles (T1, T2, and T3). Abnormal MPI for myocardial ischemia in individual coronary territories was defined as summed stress score (SSS) ≥ 4 and summed difference score (SDS) ≥ 2. SSS refers to the sum of all defects in the stress images, and SDS is the difference of the sum of all defects between the rest images and stress images. All patients were followed up for major adverse cardiac events (MACE).

Results: Among 332 INOCA patients, 113 (34.0%) had abnormal MPI. Patients with higher TyG index had a higher rate of abnormal MPI (25.5% vs. 32.4% vs. 44.1%; p = 0.012). Multivariate logistic analysis showed that a high TyG index was significantly correlated with abnormal MPI in INOCA patients (OR, 1.901; 95% CI, 1.045-3.458; P = 0.035). During the median 35 months of follow-up, 83 (25%) MACE were recorded, and a higher incidence of MACE was observed in the T3 group (T3 vs. T2 vs. T1: 36.9% vs. 21.6% vs. 16.4%, respectively; p = 0.001). In multivariate Cox regression analysis, the T3 group was significantly associated with the risk of MACE compared to the T1 group (HR, 2.338; 95% CI 1.253-4.364, P = 0.008).

Conclusion: This study indicates for the first time that the TyG index is significantly associated with myocardial ischemia and poor prognosis among INOCA patients.

Keywords: INOCA; Myocardial perfusion imaging; Prognosis; Triglyceride-glucose index.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of study patients. INOCA ischemia with non-obstructive coronary artery disease, MPI myocardial perfusion imaging, FPG fasting plasma glucose, TG triglyceride, TyG index triglyceride-glucose index
Fig. 2
Fig. 2
Comparison of TyG index in INOCA patients with normal MPI and abnormal MPI. TyG index triglyceride-glucose index, INOCA ischemia with non-obstructive coronary artery disease, MPI myocardial perfusion imaging, **P < 0.01
Fig. 3
Fig. 3
Correlation between TyG index and SSS (A), SRS (B), SDS (C) and stress TPD (D). TyG index triglyceride-glucose index, SSS summed stress score, SRS summed rest score, SDS summed difference score, TPD total perfusion defect
Fig. 4
Fig. 4
Kaplan-Meier survival curve for MACE based on TyG index tertiles. MACE major adverse cardiovascular events, 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

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