ARYA Atherosclerosis Journal

Association between Triglyceride-glucose index and coronary artery in-stent restenosis: A case-control study in an Iranian patient population

Document Type : Original Article

Authors

Rana Kolahi Ahari 1, 2
Reza Eftekhar 3, 4
Toktam Sahranavard 1, 2
Mahya Najjari 5
Soheil Karami 6
Niloofar Shabani 7
Mohammadsaleh Safavishamloo 6
Amirreza Soleimani 6
Gordon Ferns 8
Mohsen Moohebati 3, 9
Sara Saffar Soflaei 3
Majid Ghayour-Mobarhan 2, 3

1 Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran

3 Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Yazd International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

5 Department of Microbiology and Virology, Mashhad University of Medical Sciences, Mashhad, Iran

6 Student Research Committee of Mashhad University of Medical Sciences, Mashhad, Iran

7 Department of Biostatistics, School of Health, Tehran University of Medical Sciences, Tehran, Iran

8 Brighton and Sussex Medical School, Division of Medical Education, Brighton, United Kingdom

9 Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

10.48305/arya.2026.45619.3101
Abstract
BACKGROUND: The Triglyceride-glucose (TyG) index, a useful surrogate marker of insulin resistance (IR), is associated with cardiovascular disease (CVD). However, the correlation between the TyG index and coronary in-stent restenosis (ISR) remains unknown.
METHODS: A total of 325 subjects who underwent coronary angiography due to acute coronary syndrome (ACS) ≥ 1 month after stent implantation were included in this retrospective case-control study from December 2014 to April 2017. Based on ISR status (≥ 50% stenosis), 111 patients were assigned to the ISR group and 214 to the non-ISR (NISR) group. Baseline characteristics and biochemical data were gathered. Logistic regression (LR) analysis was used to evaluate the predictive value of the TyG index for ISR with different models. P < 0.05 was considered statistically significant.
RESULTS: The TyG index was significantly higher among patients with ISR compared with NISR patients (8.84 ± 0.85 vs. 8.61 ± 0.63; P = 0.010). The TyG index remained an independent predictor for ISR in all multivariable LR analysis models, with the fully adjusted model demonstrating the strongest relation (OR = 2.239; 95% CI: 1.325–3.782; P = 0.003). Furthermore, the risks for ISR were almost 5-fold greater in patients in the highest TyG quartile than in those in the lowest quartile (95% CI: 1.718–14.454; P = 0.003).
CONCLUSION: An elevated TyG index is independently linked with ISR. Consequently, the TyG index acts as a simple and pivotal marker for identifying patients at higher risk of ISR and for evaluating adverse cardiovascular outcomes.

Keywords

Triglyceride-Glucose Index
Coronary In-Stent Restenosis
Stent
Acute Coronary Syndrome
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ARYA Atherosclerosis Journal
Volume 22, Issue 3
May and June 2026
Pages 53-66

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