RESEARCH ARTICLE SA JOURNAL OF DIABETES & VASCULAR DISEASE 16 VOLUME 21 NUMBER 1 • November 2024 The predictive value of triglyceride–glucose index for assessing the severity and MACE of premature coronary artery disease Abstract Objective: The aim of this study was to investigate the predictive value of the triglyceride–glucose (TyG) index to assess the severity and major adverse cardiovascular events (MACE) of patients in hospital with premature coronary artery disease (PCAD). Methods: A total of 300 patients with PCAD, diagnosed by coronary angiography (CAG), were enrolled in this study. According to the tertiles of TyG index, the 300 patients were divided into a T1 (n = 100), T2 (n = 100) and T3 group (n = 100). According to the presence or absence of MACE, the 300 patients were divided into a MACE (n = 80) and a non-MACE group (n = 220). The patients’ clinical data were compared between the groups, the relationship between TyG index and the severity of PCAD and MACE were analysed through multivariable logistic regression analysis, and their predictive value was detected using receiver operating characteristic (ROC) curves. Results: Multivariable logistic regression analysis showed that the TyG index was an independent risk factor for the severity of PCAD and MACE. The area under the ROC curve was 0.833 and 0.807, respectively (all p < 0.05). Conclusion: The TyG index was independently associated with the severity of PCAD and MACE, and had a good predictive value. Keywords: premature coronary artery disease, triglyceride– glucose index, severity, major adverse cardiovascular events Coronary artery disease (CAD) is the most important cause of morbidity and mortality all over the world.1,2 Although coronary artery disease occurs mainly in the elderly, with the change in lifestyle and dietary habits, young individuals with CAD have become more prevalent in recent years. The onset age of CAD is also becoming younger and younger, which has become a problem that cannot be ignored.3 Premature coronary artery disease (PCAD) is a special type of CAD, which is defined as the onset of CAD before the age of 55 years in males and 65 years in females.4 In contrast to mature coronary artery disease, PCAD patients have more severe coronary artery stenosis, more vascular occlusion, higher incidence of acute coronary syndrome (ACS) and major adverse cardiovascular events (MACE).3,5 The loss of the labour force caused by PCAD will bring a heavy burden to society and families, so it is of great significance to prevent the occurrence and adverse outcomes of PCAD. Simental-Mendia et al. first discovered that the triglyceride– glucose (TyG) index was related to insulin resistance (IR), and current studies have confirmed that the TyG index is related to cardiovascular disease.6 However, most of the current studies on TyG index and cardiovascular disease have been conducted in the elderly, and there are few studies on TyG index and PCAD. We mainly explored the association between TyG index and the severity and MACE of PCAD, and analysed the predictive value of TyG index for both. This has ensured a better understanding of the clinical value of the TyG index for PCAD, and allowed us to find a simple, economical and reliable predictor of PCAD, so as to improve the clinical diagnosis and treatment of PCAD patients. Methods This was a single-centre, retrospective study. From January 2021 to June 2022, a total of 300 patients with PCAD, diagnosed by coronary angiography (CAG) at the Heart Center of the First Hospital of Lanzhou University, were selected as the subjects. CAD was defined as the presence of obstructive stenosis of ≥ 50% of the vessel lumen diameter in any of the main coronary arteries, including the left main coronary artery, left anterior descending artery, left circumflex coronary artery and right coronary artery, or the main branches of the vascular system. The inclusion criteria were as follows: their age had to meet the requirements of PACD (males ≤ 55 years, females ≤ 65 years); and all patients had to have CAG records and results at the Heart Center of our hospital. The exclusion criteria were as follows: patients with history of coronary artery revascularisation; those with heart diseases, such as myocarditis, congenital heart disease or valvular disease; those with severe liver or kidney insufficiency; those with infectious diseases; those with malignancies or other auto-immune rheumatic diseases or connective tissue diseases; and those who had recently taken medications lowering their blood lipids. This study was reviewed and approved by the ethics committee of the First Hospital of Lanzhou University. All patients were exempt from written informed consent. Clinical data were collected from the medical records by trained clinicians who were blinded to the study aim. The data included patients’ demographics (age, gender, height, weight, history of smoking and drinking), past history of hypertension and diabetes, and family history of CAD. Ling Yang, Yu Peng, Zheng Zhang Correspondence to: Zheng Zhang Yu Peng The Heart Center of the First Hospital of Lanzhou University, and the Key Laboratory of Cardiovascular Diseases of Gansu Province, Lanzhou, China e-mail: zhangccu@163.com Ling Yang The First Clinical Medicine School of Lanzhou University, Lanzhou, China Previously published online in Cardiovasc J Afr February 2024 S Afr J Diabetes Vasc Dis 2024; 21: 16–21
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