SPC365

The role of the triglyceride-glucose index as a predictor of coronary artery disease severity in young patients

Session: SESSÃO DE POSTERS 36 - TUDO SOBRE LÍPIDOS
Speaker: André Manuel Martins

Congress: CPC 2025
Topic: J. Preventive Cardiology
Theme: 28. Risk Factors and Prevention
Subtheme: 28.4 Lipids
Session Type: Cartazes
FP Number: ---
Authors: André Manuel Faustino Martins; Mónica Amado; Joana Pereira; Adriana Vazão; Carolina Gonçalves; Mariana Carvalho; Margarida Cabral; Jorge Guardado; Hélia Martins

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif"><span style="color:black">Introduction: </span></span></strong><span style="font-family:Calibri,sans-serif"><span style="color:black">The triglyceride-glucose (TyG) index has emerged as a reliable marker of insulin resistance, a recognized risk factor for coronary artery disease (CAD). Elevated TyG index values have been consistently linked to increased CAD severity. While this association is well-documented in older populations, evidence in younger patients (pts) remains scarce.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif"><span style="color:black">Objectives:</span></span></strong><span style="font-family:Calibri,sans-serif"><span style="color:black"> Evaluate the association between the TyG index and the extent of CAD in young adults, based on the number of stenosed coronary arteries (CA) detected through coronary angiography.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif"><span style="color:black">Methods: </span></span></strong><span style="font-family:Calibri,sans-serif"><span style="color:black">Retrospective single-center study of adult pts under 45 yrs of age who were admitted to our center, either electively or urgently, for cardiac catheterization due to suspected CAD between 2017 and 2023. We included only pts with significant coronary artery stenosis (&ge;70% in epicardial vessels or &ge;50% in the left main CA). Pts were classified in the single-vessel disease group (Group 1) or multi-vessel disease group (Group 2). The presence of cardiovascular risk factors and potential analytical predictors of CAD was assessed. The TyG index was calculated as ln [TG (mg/dL) &times; FBG (mg/dL)/2]. Comparative analyses were performed.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif"><span style="color:black">Results:</span></span></strong><span style="font-family:Calibri,sans-serif"><span style="color:black"> 152 pts were included; median age was 42 yrs (IQR 5) and 132 pts (86.8%) were male. 132 pts (86.8%) were urgently admitted for suspected acute coronary syndrome, with 65.2% presenting as ST-segment elevation myocardial infarction. Angiographic findings showed 95 pts (62.5%) with single-vessel disease (SVD) (Group 1), while 57 pts (37.5%) presented with multi-vessel disease (MVD) (Group 2). Group 1 pts were younger (42 [IQR 7] vs 43 [IQR 4] yrs, p=0.013), with a lower prevalence of diabetes (3.2 vs 12.3%, p=0.041) and higher smoking rates (73.1 vs 57.4%, p=0.049). They also exhibited significantly lower HbA1c, fasting blood glucose (FBG), triglycerides and TyG index levels (table 1A). Through the ROC curve analysis, the TyG index had strong predictive value for MVD (AUC 0.847, p&lt;0.001; CI 95% 0.773-0.920), with an optimal cutoff at 8.991 (80% sensitivity, 83% specificity). After multivariate logistic regression, triglycerides (OR 3.82, CI 95% 1.03-14.13) and TyG index (OR 10.93, CI 95% 2.85-41.88) were independent predictors of MVD.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif"><span style="color:black">Conclusions:</span></span></strong><span style="font-family:Calibri,sans-serif"><span style="color:black"> Consistent with previous studies in older populations, we confirmed that elevated triglycerides and TyG index independently predict complex CAD in young pts, highlighting TyG index&#39;s potential as a high-risk marker in this group.</span></span></span></span></span></p>