Associations between the serum triglyceride-glucose index and pericoronary adipose tissue attenuation and plaque features using dual-layer spectral detector computed tomography: a cross-sectional study

Predictive Value of Peri-Coronary Fat Attenuation Index in Elderly Non-ST-Elevation Myocardial Infarction and Its Correlation with Platelet to Lymphocyte Ratio

BACKGROUND

Inflammatory mediators and immune activation can intensify the inflammatory response within atherosclerotic plaques, increasing the risk of plaque rupture and thrombosis. This study aims to compare peri-coronary adipose tissue fat attenuation index (PCAT-FAI) and platelet-to-lymphocyte ratio (PLR) between NSTEMI and SA patients, and explore their combined predictive ability for NSTEMI.

PATIENTS AND METHODS

The study included 52 NSTEMI patients aged 65 and older who underwent both CCTA and CAG from January 2020 to December 2022, alongside 52 gender- and age-matched SA patients, and 52 control patients. PCAT-volume and PCAT-FAI were measured using Siemens VB20.0, and PLR was calculated from peripheral blood tests.

RESULTS

Among 156 patients, NSTEMI patients had significantly higher PCAT volume (12.13 ± 5.32 mm³) compared to SA (8.39 ± 4.10 mm³, p < 0.001) and controls (6.28 ± 3.40 mm³, p < 0.001). They also had higher PCAT-FAI (-76.28 ± 5.33 HU) than SA (-82.87 ± 6.19 HU, p < 0.001) and controls (-84.19 ± 5.74 HU, p < 0.001). PLR was higher in NSTEMI patients (178.27 ± 107.18) compared to SA (115.54 ± 45.28, p = 0.002) and controls (116.09 ± 38.09, p = 0.006), with no significant difference between SA and controls (p = 1.000). PCAT-FAI correlated with PLR (CC: 0.298; P < 0.01). Combining PLR and PCAT-FAI predicted NSTEMI with an AUC of 0.799 (95% CI, 0.715-0.883).

CONCLUSION

Higher PCAT-FAI and PLR in NSTEMI patients highlight the role of adipose tissue inflammation and thrombosis in coronary artery disease progression. Combined assessment of PCAT-FAI and PLR has potential value in predicting the adverse progression of atherosclerotic plaques.

10-year trajectories of triglyceride-glucose index and progression of vertebrobasilar artery stenosis: A multicenter hospital-based prospective longitudinal cohort study

BACKGROUND

The association between the triglyceride-glucose (TyG) index and the atherosclerosis has been validated by numerous evidences. However, the prospective relationship between long-term dynamic changes in the TyG index and the progression of vertebrobasilar artery (VBA) atherosclerotic plaques remained unclear.

METHODS

This multicenter, hospital-based, prospective longitudinal cohort study included 1,336 patients with suspected stroke from January 1, 2004 to December 31, 2022. Baseline characteristics and vascular examinations were collected and performed at baseline. Patients were followed up for 10 years. The latent class trajectory modeling method was used to analyze the TyG index trajectories over the follow-up period. Cox regression was used to analyze the association of the baseline and trajectory of the TyG index with the progression of VBA plaques.

RESULTS

During the follow-up (10.80 ± 2.30 years), VBA plaque progression was found in 175 participants. Cox regression analysis indicated there was a significant positive association between the baseline TyG index and the VBA plaque progression (HR 1.886, 95 % CI 1.166-3.050, P = 0.010). Two trajectories of the TyG index were identified in a total of 1,336 participants, the low-stable group and high-increasing group. Compared with the low-stable group, the odds ratio for the high-increasing group had a 3.156-fold (95 % CI 1.629-6.112, P = 0.001) risk of VBA plaque progression.

CONCLUSIONS

Our findings suggested that higher baseline and the high-increasing trajectory of the TyG index were associated with VBA plaque progression. People with high-increasing trajectories of the TyG index predispose to develop VBA plaque progression and deserve more attention and more aggressive preventive therapies.

The triglyceride-glucose index is a predictor of major adverse cardiovascular events in patients with coronary artery disease and psoriasis: a retrospective cohort study

BACKGROUND

The association between the triglyceride-glucose (TyG) index and clinical outcomes in patients with both coronary artery disease (CAD) and psoriasis is unclear. This study investigated the association between the TyG index and major adverse cardiovascular events (MACE) in patients with both CAD and psoriasis.

METHODS

This retrospective cohort study included patients diagnosed with both CAD and psoriasis who underwent coronary angiography at the Fuwai Hospital, Beijing, China, between January 2017 and May 2022. The study endpoint was the occurrence of MACE or end of follow-up time. Multivariate Cox proportional analysis and restricted cubic splines (RCS) were used to determine the association between the TyG index and MACE. Receiver operating characteristic (ROC) curves were used to determine the optimal threshold value of the TyG index for predicting MACE.

RESULTS

This study enrolled 293 patients with both CAD and psoriasis, including 258 (88.1%) males with a mean age of 58.89 ± 9.61 years. Patients were divided into four groups based on the TyG quartiles: Q1 (N = 74), Q2 (N = 73), Q3 (N = 73), and Q4 (N = 73). After adjusting for the potential confounders, the TyG index was independently associated with MACE, both as a continuous variable (HR = 1.53, 95% CI = 1.03-2.28, P = 0.035) and as a categorical variable (Q1: reference; Q2: HR = 1.85, 95% CI = 0.88-3.87, P = 0.105; Q3: HR = 2.39, 95% CI = 1.14-5.00, P = 0.021; Q4: HR = 2.19, 95% CI = 1.001-4.81, P = 0.0497; P for trend = 0.039). RCS analysis showed an linear association between the TyG index and MACE (P-overall = 0.027, P-non-linear = 0.589). ROC curve analysis showed that the TyG index of ≥ 8.73 was the optimal threshold value (area under the ROC curve = 0.60, 95% CI 0.53-0.67). TyG index ≥ 8.73 was significantly associated with MACE (HR = 2.10, 95% CI = 1.32-3.34, P = 0.002). After adjustment for confounders, the TyG index showed independent association with MACE (HR = 2.00, 95% CI = 1.17-3.42, P = 0.011).

CONCLUSIONS

The TyG index showed a positive linear correlation with MACE in patients with both CAD and psoriasis. The TyG index of ≥ 8.73 might be the optimal threshold for predicting MACE.

Relationship Analysis Between Pericoronary Fat Attenuation Index and Parameters of Single Plaque

OBJECTIVE

The aim of the study is to investigate the relationship between plaque parameters and pericoronary fat attenuation index (FAI).

METHODS

A retrospective collection was performed on 227 patients with coronary heart disease who underwent coronary computed tomography angiography examinations in our hospital from May 2021 to April 2023, with a total of 254 right coronary or left anterior descending coronary arteries exhibiting solitary plaques within the FAI measurement area. Based on whether the proximal coronary FAI value was ≥ -70.0 HU, patients and coronary arteries were divided into FAI-positive group (67 cases, 73 coronary arteries) and FAI-negative group (160 cases, 181 coronary arteries). Quantitative parameters of coronary solitary plaques were collected, including stenosis severity, plaque length, plaque volume, plaque composition ratios, minimal luminal area, and calcification score, as well as qualitative parameters such as plaque types and high-risk plaques. Differences in plaque parameters between the FAI-positive and FAI-negative groups were compared.

RESULTS

The proportion of positive remodeling in the FAI-positive group (73 coronary arteries) was higher than that in the FAI-negative group (181 coronary arteries) with statistical significance (89.0% vs 78.5%, P = 0.049). Multivariate analysis revealed that positive remodeling was a risk factor for abnormal FAI values in solitary plaques (odds ratio, 2.271, P = 0.049).

CONCLUSIONS

The FAI-positive group had a higher proportion of positive remodeling, and positive remodeling was an independent risk factor for positive FAI values.

Association between the triglyceride glucose index and chronic total coronary occlusion: A cross-sectional study from southwest China

BACKGROUND AND AIM

Insulin resistance (IR) plays an important role in the atherosclerotic process, and the triglyceride glucose (TyG) index is a reliable indicator of IR and is strongly associated with cardiovascular disease. However, there are few studies regarding the relationship between the TyG index and chronic total coronary occlusion (CTO). Herein, the correlation between the TyG index and CTO, as well as their interactions with other traditional cardiovascular risk factors, were investigated.

METHODS AND RESULTS

We enrolled 2691 patients who underwent coronary angiography at Guangyuan Central Hospital from January 2019 to October 2021. TyG index results were used to create three groups using the trichotomous method. CTO was defined as complete occlusion of the coronary artery for ≥3 months. Univariate and multivariate logistic regression models, restricted cubic splines, receiver operating characteristic (ROC) curves, and subgroup analyses was performed. A significant correlation between the TyG index and CTO was noted. The risk of CTO was increased 2.09-fold in the group with the highest TyG compared with the lowest (OR, 2.09; 95 % CI, 1.05-4.17; P = 0.036). In addition, there was a linear dose-response relationship between the TyG index and CTO (nonlinear P = 0.614). The area under the ROC curve was 0.643 (95 % CI, 0.572-0.654). Using subgroup analyses, we observed that the TyG index was associated with a significantly higher risk of CTO in males and smokers.

CONCLUSIONS

An elevated TyG index was related to the risk of CTO and may constitute a meaningful predictor of CTO, particularly in males and in smokers.

Triglyceride glucose index is associated with functional coronary artery stenosis in hypertensive patients

Background

The triglyceride glucose (TyG) index is an effective method for determining insulin resistance (IR). Limited research has explored the connection between the TyG index and functionally significant stenosis in hypertensive patients. Furthermore, the connections between the TyG index, fat attenuation index (FAI) and atherosclerotic plaque characteristics are also worth exploring.

Methods

The study screened 1622 hypertensive participants without coronary artery disease history who underwent coronary computed tomography angiography. The TyG index was calculated as ln (fasting glucose [mg/dL] * fasting TG [mg/dL]/2). Adverse plaque characteristics (HRPCs), high-risk plaques (HRPs), FAI, and CT-derived fractional flow reserve (FFRCT) were analyzed and measured for all patients. Functionally significant stenosis causing ischemia is defined as FFRCT ≤ 0.80. Two patient groups were created based on the FFRCT: the FFRCT < 0.80 group and the FFRCT > 0.80 group. In hypertensive patients, the association between the TyG index and FFRCT was examined applying a logistic regression model.

Results

The TyG index was higher for people with FFRCT ≤ 0.80 contrast to those with FFRCT > 0.80. After controlling for additional confounding factors, the logistic regression model revealed a clear connection between the TyG index and FFRCT ≤ 0.80 (OR = 1.718, 95% CI 1.097-2.690, p = 0.018). The restricted cubic spline analysis displayed a nonlinear connection between the TyG index and FFRCT ≤ 0.80 (p for nonlinear = 0.001). The TyG index increased the fraction of individuals with HRPs and HRPCs, FAI raised, and FFRCT decreased (p < 0.05). The multivariate linear regression analysis illustrated a powerfulcorrelation between high TyG index levels and FAI, FFRCT, positive remodeling (PR), and low-attenuation plaque (LAPs) (standardized regression coefficients: 0.029 [p = 0.007], -0.051 [p < 0.001], 0.029 [p = 0.027], and 0.026 [p = 0.046], separately).

Conclusion

In hypertensive patients, the TyG index showed an excellent association with a risk of FFRCT ≤ 0.80. Additionally, the TyG index was also linked to FAI, FFRCT, PR, and LAPs.

Triglyceride glucose index and renal function decline in Han Chinese hypertensive patients

Elevated triglyceride glucose (TyG) index is associated with an increased risk of cardiovascular disease. The current study aimed to investigate whether the TyG index was correlated with renal function decline in patients with hypertension. Han Chinese participants with essential hypertension were included. The TyG index was calculated as ln[fasting triglycerides (mg/dL) * fasting glucose (mg/dL)/2]. Renal function decline was defined as >25% decline in estimated glomerular filtration rate (eGFR). The Cox proportional hazard regression model was used to examine the independent effect of the TyG index on renal events. In total, 548 Han Chinese hypertensive participants with a mean age of 62.1 ± 14.3 years were eligible for enrollment. During a mean follow-up period of 4.7 ± 3.1 years, 97 patients suffered from >25% decline in eGFR. When compared to those without eGFR decline, patients with eGFR decline had higher fasting triglyceride levels (P = .056), fasting glucose levels (P = .014), and TyG indexes (P = .014). The Cox proportional hazard regression model revealed that the TyG index (hazard ratio [HR] = 1.490; 95% confidence interval [CI] = 1.016-2.185, P = .041), office systolic blood pressure (HR = 1.013; 95% CI = 1.000-1.026, P = .047), diabetes mellitus (HR = 1.797, 95% CI = 1.026-3.147, P = .040), and baseline eGFR (HR = 1.015; 95% CI = 1.002-1.028, P = .025) were associated with renal events. In conclusions, an elevated TyG index is independently associated with an increased risk of eGFR decline in hypertensive patients.