Document Type : Original Article

Authors

• Soodeh Jahangiri ¹
• Seyed Arad Mosalamiaghili ²
• Reza Heydarzadeh ^{3, 4}
• Mohammadali Yousefzadeh ⁵
• Reza Golchin Vafa ^{3, 4}
• Hooyar Zarifkar ^{3, 4}
• Kasra Assadian ²
• Sina Sohrabizadeh ³
• Hourshad Zarifkar ^{3, 4}
• Mehrdad Sadeghi ⁴
• Nazanin Hosseini ⁴
• Mohammad Montaseri ⁴
• Seyed Ali Hosseini ⁴
• Javad Kojuri ^{3, 4, 6, 7}

¹ Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran

² Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

³ Shiraz University of Medical Sciences, Shiraz, Iran

⁴ Professor Kojuri Cardiology Clinic, Shiraz, Iran

⁵ Department of Civil and Environmental Engineering, Shiraz University, Shiraz, Iran

⁶ Cardiology Department, Shiraz University of Medical Sciences, Shiraz, Iran

⁷ Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

BACKGROUND: The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio, Metabolic Score for Insulin Resistance (METS-IR), triglyceride-glucose (TyG) index, and triglyceride-glucose body mass index (TyG-BMI) have been associated with the occurrence and severity of coronary artery disease (CAD), although evidence remains limited.
METHODS: A total of 1,017 patients undergoing coronary angiography for the first time were included. Insulin resistance (IR) indices were calculated based on patients’ laboratory data. Significant CAD was defined as more than 50% stenosis observed in coronary angiography1.
RESULTS: A positive correlation was found between CAD and the TyG index (ρ = 0.083, p = 0.008). Patients with CAD had a significantly elevated TyG index (9.02 ± 0.62) compared to those with single-vessel disease (SVD) (8.87 ± 0.59) (p = 0.012). A strong association was observed between CAD and the TG/HDL-C ratio (ρ = 0.114, p < 0.001). Patients with multi-vessel disease exhibited a considerably higher index (4.47 ± 2.46) compared to those with SVD (3.77 ± 2.45) (p = 0.003). The TyG index cut-off was 9.22 (27.5% sensitivity, 79.3% specificity, 82.2% positive predictive value (PPV), and 23.89% negative predictive value (NPV)), while the TG/HDL-C ratio cut-off was 3.6 (44% sensitivity, 65.2% specificity, 81.5% PPV, and 25.5% NPV).
CONCLUSION: Our findings indicate that the TG/HDL-C ratio, with a cut-off point of 3.6, and the TyG index, with a threshold of 9.22, are associated with the presence of CAD. (ClinicalTrials.gov registration number: NCT06237244).

Keywords

• Coronary Artery Disease
• Insulin Resistance Indices