Objective To evaluate the value of triglyceride-glucose body mass index (TyG-BMI) and serum vascular endothelial growth factor (VEGF) levels in predicting the severity of coronary artery lesions in patients with coronary heart disease (CHD).

Methods A total of 454 CHD patients selected to Taizhou Hospital of Traditional Chinese Medicine from September 2024 to July 2025 were included as the study subjects. All patients underwent coronary angiography and relevant laboratory tests. Based on the Gensini score results, the severity of the disease was assessed, and the patients were divided into mild group (Gensini score ≤ 20 points, n=223) and moderate-to-severe group (Gensini score>20 points, n=231). Baseline data were compared between the two groups. The correlations of TyG-BMI and VEGF with the Gensini score were analyzed. The value of TyG-BMI and VEGF in predicting moderate-to-severe lesions was also analyzed.

Results The proportions of patients with a history of hypertension, diabetes, and smoking, as well as age, triglyceride (TG), fasting blood glucose (FBG), TyG-BMI, VEGF, and low-density lipoprotein cholesterol (LDL-C) levels were higher in the moderate-to-severe group than those in the mild group, while high-density lipoprotein cholesterol(HDL-C) levels were lower in the moderate-to-severe group (P < 0.05). When the severity of CHD lesions was regarded as the dependent variable and the statistically significant indicators were included as independent variables in a logistic regression analysis model, the results showed that a history of smoking, advanced age, high TG, high TyG-BMI, high VEGF, and high LDL-C were independent risk factors for CHD patients, while high HDL-C was a protective factor for lesion severity in CHD patients. Receiver operating characteristic (ROC) curve analysis showed that the areas under the curve for TyG-BMI and VEGF in predicting moderate and severe CHD lesions were 0.708 and 0.670, respectively, and the area under the curve for their combined prediction was 0.831. Correlation analysis showed that TyG-BMI (r=0.484, P < 0.05), VEGF (r=0.391, P < 0.05), and their combination (r=0.608, P < 0.05) were positively correlated with an increase in the Gensini score in CHD patients.

Conclusion TyG-BMI and VEGF levels are closely related to severe CHD lesions. Both have important application values in the non-invasive diagnosis and treatment of CHD, and can provide a reliable basis for the early screening of high-risk populations with moderate and severe coronary artery lesions.