Erbay Ilke, Gudul Naile Eris, Kokturk Ugur, Avci Ahmet
Department of Cardiology, Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey.
Coron Artery Dis. 2025 Mar 1;36(2):151-157. doi: 10.1097/MCA.0000000000001466. Epub 2024 Nov 25.
Non-ST-segment elevation acute coronary syndrome (NSTE-ACS) has a significant impact on cardiovascular mortality in elderly patients. Identification of high-risk patients is essential to optimize clinical management. This study investigates the relationship between the TyG index and CAD complexity, as measured by the SYNTAX score, in elderly patients with NSTE-ACS.
We performed a retrospective analysis of 216 patients aged >65 years undergoing coronary angiography stratified according to tertiles of the TyG index and the SYNTAX score (SYNTAX score ≤ 22 versus SYNTAX score > 22).
After adjustment for confounders, the TyG index was identified as an independent predictor of moderate/high scores (SYNTAX score > 22). As a continuous variable, it was significantly associated with moderate/high SYNTAX scores in both diabetic ( P = 0.003) and nondiabetic groups ( P = 0.004). When presented as a categorical variable, the TyG index remained a significant predictor after adjustment for sex, hypertension, BMI, and glomerular filtration rate. Compared with the T1 group, the risk of a moderate/high SYNTAX score was 5.410-fold (95% CI: 1.034-28.315; P = 0.046) and 7.774-fold (95% CI: 1.836-32.916; P = 0.005) higher in the T2 and T3 groups, respectively. The TyG index showed superior predictive ability for CAD complexity with an AUC of 0.747 compared with the AUC of 0.624 for HbA1c ( P = 0.005).
This study showed that the TyG index is an independent predictor of moderate/high SYNTAX scores in elderly patients with NSTE-ACS, demonstrating superior predictive performance compared to HgA1c and highlighting its potential as a valuable tool for assessing CAD severity in this population.
非ST段抬高型急性冠状动脉综合征（NSTE-ACS）对老年患者的心血管死亡率有重大影响。识别高危患者对于优化临床管理至关重要。本研究调查了老年NSTE-ACS患者中TyG指数与通过SYNTAX评分衡量的CAD复杂性之间的关系。
我们对216例年龄>65岁接受冠状动脉造影的患者进行了回顾性分析，这些患者根据TyG指数和SYNTAX评分（SYNTAX评分≤22与SYNTAX评分>22）的三分位数进行分层。
在调整混杂因素后，TyG指数被确定为中度/高分（SYNTAX评分>22）的独立预测因素。作为连续变量，它在糖尿病组（P = 0.003）和非糖尿病组（P = 0.004）中均与中度/高SYNTAX评分显著相关。当作为分类变量呈现时，在调整性别、高血压、BMI和肾小球滤过率后，TyG指数仍然是一个显著的预测因素。与T1组相比，T2组和T3组中度/高SYNTAX评分的风险分别高5.410倍（95%CI：1.034-28.315；P = 0.046）和7.774倍（95%CI：1.836-32.916；P = 0.005）。TyG指数对CAD复杂性的预测能力优于HbA1c，AUC为0.747，而HbA1c的AUC为0.624（P = 0.005）。
本研究表明，TyG指数是老年NSTE-ACS患者中度/高SYNTAX评分的独立预测因素，与糖化血红蛋白相比具有更好的预测性能，并突出了其作为评估该人群CAD严重程度的有价值工具的潜力。
