Abstract
Background: Recent studies have substantiated the role of triglyceride glucose index (TyG index) in the prognosis of coronary artery disease (CAD) patients while no relevant studies revealed the association between TyG index and coronary collateral circulation (CCC) in the event of coronary chronic total occlusion (CTO). Our study intends to explore whether or to what extent TyG index is associated with less developed CCC in CAD patients with CTO lesions.Methods: The study enrolled 1093 ACS patients undergoing percutaneous coronary intervention (PCI) for at least one CTO lesion. Relevant data was collected from Beijing Anzhen Hospital record system. The degree of collaterals was determined according to Rentrop classification system. The correlation between TyG index and coronary collateralization was assessed.Results: Overall, 318 patients were divided into poor CCC group. TyG index was significantly higher in patients with poor CCC (9.3±0.65 vs. 8.8±0.53, P＜0.001). After adjusting for various confounding factors, TyG index remained to be correlated with the occurrence of poor CCC, with an ORs (95% CIs) of 1.59 (1.07-2.36) in T2 group and 5.72 (3.83-8.54) in T3 group compared with the first tertile. Besides, subgroup analysis showed that higher TyG index values remained to be strongly associated with increased risks of poor CCC. Lastly, to compare the risk assessment efficacy for the formation of CCC between TyG index and glycosylated hemoglobin A1c (HbA1c) and another insulin resistance (IR) surrogate marker triglyceride-to-high-density lipoprotein cholesterol ratio, area under the receiver-operating characteristic (ROC) curve (AUC) was obtained, a significant improvement on the risk assessment performance for the poor CCC emerged when adding TyG index into a baseline model [AUC, 0.629 for baseline model vs. 0.724 for baseline model + TyG index vs. 0.638 for baseline model +HbA1c vs. 0.721 for baseline model +TG/HDL-C, P<0.001; net reclassification improvement (NRI) for TyG index, 0.238, P＜0.001; integrated discrimination improvement (IDI) for TyG index, 0.103, P＜0.001].Conclusions: The TyG index is strongly associated with the occurrence of poor CCC in CAD patients with CTO lesions and its risk assessment performance is better than HbA1c and TG-to-HDL-C ratio.
The Association between Whole Blood Viscosity and Coronary Collateral Circulation in Patients with Chronic Total Occlusion
