PREDICTION OF SEVERITY OF CORONARY ARTERY DISEASE IN PATIENTS WITH ACUTE CORONARY SYNDROME BY TRIGLYCERIDE GLUCOSE INDEX

Abstract

Objective: To evaluate the association between the triglyceride-glucose (TyG) index and the severity and complexity of coronary artery disease in patients with acute coronary syndrome. Methodology: This retrospective observational study was conducted in the Cardiology Department, Punjab Institute of Cardiology Lahore from March 2025 to September 2025. A total of 200 patients with acute coronary syndrome who underwent coronary angiography were included. Biochemical parameters were measured after an 8-hour overnight fast, and the TyG index was calculated. The severity of coronary artery disease was assessed using the SYNTAX score, calculated from preprocedural coronary angiograms through an online scoring tool. Patients were categorized into low and moderate-to-high SYNTAX score groups. Multivariate analysis was performed to assess the independent predictive value of the TyG index, while Spearman’s correlation test was used to determine its relationship with CAD severity. Results: Multivariate analysis demonstrated that the TyG index was independently associated with complex coronary artery disease, with an odds ratio of 2.66 (95% CI: 1.86–3.70, p < 0.001). Spearman’s correlation analysis also showed a weak but statistically significant positive relationship between the TyG index and CAD severity (r = 0.019, p < 0.001). Conclusion: The triglyceride-glucose index was found to be an independent predictor of coronary artery disease severity, irrespective of diabetes status. Higher TyG index values were positively associated with more complex coronary artery disease in patients with acute coronary syndrome.