Citation: | MAO Juncong, HONG Yunfei, WEI Yin, CAI Yerui, YIN Jinsong. Application values of triglyceride and glucose index, metabolic insulin resistance score and triglyceride to high-density lipoprotein cholesterol ratio in patients with acute coronary syndrome complicated with multivessel coronary artery disease[J]. Journal of Clinical Medicine in Practice, 2025, 29(5): 56-63. DOI: 10.7619/jcmp.20243599 |
To evaluate the predictive abilities of the triglyceride and glucose (TyG) index, metabolic insulin resistance score (METSIR), and ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) for the risk of onset and severity of lesions in patients with acute coronary syndrome (ACS) complicated with multivessel coronary artery disease.
A retrospective analysis was conducted on the clinical data of 260 ACS patients admitted to Yunnan Provincial Third People's Hospital, and the patients were divided into multivessel disease group (n=160) and non-multivessel disease group (n=100); based on the SYNTAX score, the multivessel disease group was further divided into high-risk group with 71 cases (score>22.5) and low-risk group with 89 cases (score ≤22.5).
The multivessel disease group had significantly higher proportions of males, history of diabetes, history of smoking, TyG index, METSIR, and TG/HDL-C compared to the non-multivessel disease group (P < 0.05). Correlation analysis showed that the TyG index and TG/HDL-C were significantly positively correlated with the SYNTAX score (P < 0.05), while METSIR had no correlation with the SYNTAX score (P>0.05). Logistic regression analysis indicated that METSIR was an independent risk factor for ACS complicated with multivessel coronary artery disease (P < 0.05), and TyG, METSIR and TG/HDL-C were all independent factors for predicting the severity of lesions (P < 0.05). Receiver operating characteristic (ROC) curve analysis showed that TyG had the highest predictive value for ACS complicated with multivessel coronary artery disease and its severity (area under the curve was 0.804).
The TyG index, METSIR, and TG/HDL-C are of great significance in the early identification and assessment of ACS complicated with multivessel coronary artery disease, with TyG having the highest predictive value.
[1] |
TAN S C W, ZHENG B B, TANG M L, et al. Global burden of cardiovascular diseases and its risk factors, 1990-2021: a systematic analysis for the global burden of disease study 2021[J]. QJM, 2023: hcaf022.
|
[2] |
YANG J X, WANG K X, WANG W J, et al. The effect of sleep quality on coronary lesion severity and prognosis in the young acute coronary syndrome population[J]. J Cardiovasc Dev Dis, 2024, 11(2): 68.
|
[3] |
KOSMAS C E, BOUSVAROU M D, KOSTARA C E, et al. Insulin resistance and cardiovascular disease[J]. J Int Med Res, 2023, 51(3): 3000605231164548. doi: 10.1177/03000605231164548
|
[4] |
KASEM S M, SAIED G M, HEGAZY A N M, et al. Impact of acute insulin resistance on myocardial blush in non-diabetic patients undergoing primary percutaneous coronary intervention[J]. Front Cardiovasc Med, 2021, 8: 647366. doi: 10.3389/fcvm.2021.647366
|
[5] |
CHEN X, WANG Y, ZHANG L. Insulin resistance as an independent predictor of cardiovascular events in type 2 diabetes[J]. Diabetes Res Clin Pract, 2023, 201: 110765-110772.
|
[6] |
SMITH A B, JOHNSON C D, BROWN E F. Synergistic effects of impaired glucose tolerance and insulin resistance on cardiovascular risk in obese pre-diabetes[J]. J Am Heart Assoc, 2024, 13(5): e029876-e029883.
|
[7] |
中国医师协会急诊医师分会, 国家卫健委能力建设与继续教育中心急诊学专家委员会, 中国医疗保健国际交流促进会急诊急救分会. 急性冠脉综合征急诊快速诊治指南(2019)[J]. 中华急诊医学杂志, 2019, 28(4): 421-428.
|
[8] |
王锦. 血浆B型利钠肽变化水平与冠脉病变程度的关系[D]. 石家庄: 河北医科大学, 2020.
|
[9] |
GRESNIGT F J, SMITS E S, DEN HAAN C, et al. The association of amfetamines and cathinones with acute coronary syndrome - a systematic review[J]. Clin Toxicol (Phila), 2023, 61(5): 336-345.
|
[10] |
CAI X T, GAO J, HU J L, et al. Dose-response associations of metabolic score for insulin resistance index with nonalcoholic fatty liver disease among a non-obese Chinese population: retrospective evidence from a population-based cohort study[J]. Dis Markers, 2022, 2022: 4930355.
|
[11] |
YANG H F, GONG R P, LIU M L, et al. HOMA-IR is positively correlated with biological age and advanced aging in the US adult population[J]. Eur J Med Res, 2023, 28(1): 470.
|
[12] |
UYSAL E, TAMMO O, SOYLEMEZ E, et al. Significance of measuring anthropometric and atherogenic indices in patients with polycystic ovary syndrome[J]. BMC Endocr Disord, 2024, 24(1): 160.
|
[13] |
PAN G Y, CHEN J Z, LV C Y, et al. The clinical significance of ischaemia-modified albumin in acute coronary syndrome and hypertension[J]. Cardiol Young, 2024, 34(4): 748-753.
|
[14] |
BAJDECHI M, GURGHEAN A, BATAILA V, et al. Cardiovascular risk factors, angiographical features and short-term prognosis of acute coronary syndrome in people living with human immunodeficiency virus: results of a retrospective observational multicentric Romanian study[J]. Diagnostics, 2023, 13(9): 1526.
|
[15] |
O'CONNOR R D, HOFLAND E, LATTEN G, et al. Kounis syndrome, the allergic acute coronary syndrome[J]. Ned Tijdschr Geneeskd, 2019, 163: D3250.
|
[16] |
WOZNIAK P, STEPIEÑK, WAÑHA W, et al. One-year prognosis for patients diagnosed with acute coronary syndrome compared to those with chronic coronary syndrome following complex coronary procedures[J]. J Clin Med, 2025, 14(3): 730.
|
[17] |
MEI Y X, JIN Z C, MA W G, et al. Optimizing acute coronary syndrome patient treatment: leveraging gated transformer models for precise risk prediction and management[J]. Bioengineering, 2024, 11(6): 551.
|
[18] |
WANG X T, WANG Z Y, LI B, et al. Prognosis evaluation of universal acute coronary syndrome: the interplay between SYNTAX score and ApoB/ApoA1[J]. BMC Cardiovasc Disord, 2020, 20(1): 293.
|
[19] |
LIU X, ABUDUKEREMU A, JIANG Y, et al. U-shaped association between the triglyceride–glucose index and atrial fibrillation incidence in a general population without known cardiovascular disease[J]. Cardiovasc Diabetol, 2023, 22(1): 118.
|
[20] |
MIN Y, WEI X Y, WEI Z G, et al. Prognostic effect of triglyceride glucose-related parameters on all-cause and cardiovascular mortality in the United States adults with metabolic dysfunction-associated steatotic liver disease[J]. Cardiovasc Diabetol, 2024, 23(1): 188.
|
[21] |
HE H M, XIE Y Y, CHEN Q, et al. The synergistic effect of the triglyceride-glucose index and a body shape index on cardiovascular mortality: the construction of a novel cardiovascular risk marker[J]. Cardiovasc Diabetol, 2025, 24(1): 69.
|