Impact of triglyceride-glucose index on intracoronary thrombus burden in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention

• Published in: Nutrition, metabolism, and cardiovascular diseases Vol. 34; no. 4; pp. 860 - 867
• Main Authors: Köktürk, Uğur, Önalan, Orhan, Somuncu, Mustafa Umut, Akgül, Özgür, Uygur, Begüm, Püşüroğlu, Hamdi
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.04.2024
• Subjects: Coronary Angiography; Glucose; HOMA-IR; Humans; Myocardial Infarction; Percutaneous Coronary Intervention - adverse effects; Retrospective Studies; Risk Factors; ST Elevation Myocardial Infarction - diagnostic imaging; ST Elevation Myocardial Infarction - therapy; ST-elevation myocardial infarction; Thrombosis; thrombus burden; Triglycerides; TyG index; STB; ST-elevation myocardial infarction; TyG; TyG index; IR; HOMA-IR; thrombus burden; TG; TIMI; PCI; STEMI; LTB; FPG; BMI
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2023.12.025

We aimed to investigate the relationship between triglyceride glucose (TyG) index and intracoronary thrombus burden in patients with ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). A total of 468 consecutive patients who were admitted with STEMI and underwent primary PCI were included in the study. TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. According to the angiographic reclassified thrombolysis in myocardial infarction (TIMI) thrombus grade, patients were divided into two groups as small thrombus burden (STB) with TIMI thrombus grade 0–3, and large thrombus burden (LTB) with TIMI thrombus grade 4–5. TyG index was significantly higher in the LTB group than in the STB group (9.11 ± 0.86 vs 8.89 ± 0.62; p = 0.002). In multivariate analysis, TyG index was found to be an independent predictor of LTB in STEMI patients who underwent primary PCI [OR (95 % CI): 1.470 (1.090–1.982), p = 0.012]. The area under the curve (AUC) of TyG index predicting LTB was 0.568 (95 % CI 0.506–0.631; p = 0.023), with the best cut-off value of 8.87. In the classification according to TyG index cut-off value, the frequency of LTB was found to be significantly higher in the high TyG index group than in the low TyG index group (33.6 % vs 21.2 %; p = 0.003). TyG index, a valid surrogate marker of insulin resistance, is an independent predictor of LTB in STEMI patients who underwent primary PCI and can be used as an indicator of increased intracoronary thrombus burden. •Insulin resistance (IR) is an important risk factor for cardiovascular disease and poor clinical outcomes.•The TyG index is a reliable, cost-effective and valid IR surrogate marker.•The TyG index was observed as an independent predictor of LTB in STEMI patients undergoing primary PCI.•Multivariate analysis showed that TyG index may be better predictor of LTB compared to HOMA-IR as an independent predictor.