Validity of the Triglyceride-Glucose Indices for Predicting the Severity of Coronary Artery Disease in Patients with Nondiabetic Chronic Coronary Syndrome.

BACKGROUND: The triglyceride-glucose (TyG) index was shown to be an independent predictor of coronary artery disease (CAD) progression and prognosis. However, whether the TyG index can predict the severity of CAD in nondiabetic patients with chronic coronary syndrome (CCS) remains unclear.

METHODS: A total of 118 individuals who underwent elective coronary angiography (CA) were classified into group A (59 with coronary lesions) and group B (59 with normal coronary arteries; as a control group) after CA, laboratory tests for fasting and the postprandial (PP) TyG index. The complexity of CAD was determined by the SYNTAX score (SYNTAX score > 22 indicated moderate-high risk), and patients diagnosed diabetes or prediabetes were excluded.

RESULTS: The TyG index was not related to the SYNTAX score in groups A and B; however, in the CAD group with an LDL concentration <70 mg/dl (group A1), a fasting TyG index ≥ 8.25 and a PP TyG index ≥ 11 could predict moderate-high SYNTAX risk score; in addition, the odds ratio was 4.3 times higher, and the relative risk was 1.8 times greater (OR=4.3, RR=1.8, 95% CI=1.4-13.5 p<0.05) for individuals with a higher fasting TyG index ≥8.25 to have a moderate-high SYNTAX risk score. Individuals with a higher PP TyG index ≥11 had odds ratio of 2.6 times higher and a relative risk of 1.4 times greater to have moderate-high SYNTAX risk score.

CONCLUSIONS: Both fasting and postprandial TyG levels were associated with greater coronary anatomical complexity (SYNTAX score > 22) in nondiabetic chronic coronary patients with LDL <70 mg/dL. Fasting and the postprandial TyG indices can serve as noninvasive predictors of CAD complexity in nondiabetic patients with LDL <70 mg/dl and could change the management and therapeutic approach.