Nan Jing, Meng Shuai, Jia Ruofei, Chen Wei, Yang Xingsheng, Hu Hongyu, Han Lijun, Jin Zening
Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, P. R. China.
BMC Cardiovasc Disord. 2025 Apr 30;25(1):340. doi: 10.1186/s12872-025-04794-6.
The coronary slow flow phenomenon (CSFP) represents a common condition in patients with ischemia and non-obstructive coronary artery disease (INOCA). The triglyceride-glucose index (TyG) and relative modified indices have been established to be associated with CSFP. However, comparison of the clinical value of TyG and its modified indices in predicting CSFP has not been evaluated.
INOCA patients were retrospectively enrolled. According to the corrected TIMI counts, the patients were divided into the CSFP group and the non-CSFP group. A total of 4,627 patients were enrolled in our study. Among them, 69 patients were divided into the CSFP group, while 586 patients were divided into the non-CSFP group. Demographic, clinical risk factors, and laboratory results, including TyG and its modified indices, were compared between the two groups. The prognostic value of TyG and its modified indices in CSFP was compared using the area under the curve (AUC).
Most of the demographic and clinical risk factors between CSFP patients and non-CSFP patients were comparable. For patients with CSFP, the patients were more likely to have chronic kidney disease (CKD) (39.13% vs. 20.31%, p < 0.001) and less likely to have anti-diabetic therapy (14.49% vs. 27.13%, p = 0.023). The patients with CSFP also had higher body weight index (BMI) (p < 0.001), higher levels of uric acid (UA), triglyceride (TG) (p = 0.017), total cholesterol (TC) (p = 0.016) and low-density lipoprotein cholesterol (LDL-C) (p = 0.006), homocysteine (p < 0.001) and uric acid (p < 0.002). Both TyG and its modified indices, including TyG-WC, TyG-BMI were demonstrated to be independently associated with CSFP in multi-variable logistic analysis after adjusting other co-variables.Further receiver operating characteristic (ROC) curve demonstrated that TyG-WC showed the best performance in predicting CSFP compared with other indices. Subgroup analysis revealed that the predictive value of TyG-WC in CSFP was consistent in different subgroups except that the predictive value was better in male patients compared with female patients, CONCLUSIONS: Our investigation reveals that TyG, TyG-WC and TyG-BMI were independent risk factors for CSFP. TyG-WC showed a better predictive performance than other indices in predicting CSFP.
冠状动脉慢血流现象（CSFP）是缺血性和非阻塞性冠状动脉疾病（INOCA）患者的常见情况。甘油三酯-葡萄糖指数（TyG）及其相对修正指数已被证实与CSFP有关。然而，TyG及其修正指数在预测CSFP方面的临床价值比较尚未得到评估。
回顾性纳入INOCA患者。根据校正的TIMI计数，将患者分为CSFP组和非CSFP组。本研究共纳入4627例患者。其中，69例患者被分为CSFP组，586例患者被分为非CSFP组。比较两组患者的人口统计学、临床危险因素和实验室检查结果，包括TyG及其修正指数。使用曲线下面积（AUC）比较TyG及其修正指数在CSFP中的预后价值。
CSFP患者和非CSFP患者的大多数人口统计学和临床危险因素具有可比性。对于CSFP患者，其更易患慢性肾脏病（CKD）（39.13%对20.31%，p<0.001），接受抗糖尿病治疗的可能性较小（14.49%对27.13%，p=0.023）。CSFP患者的体重指数（BMI）也更高（p<0.001），尿酸（UA）、甘油三酯（TG）（p=0.017）、总胆固醇（TC）（p=0.016）和低密度脂蛋白胆固醇（LDL-C）（p=0.006）、同型半胱氨酸（p<0.001）和尿酸水平更高（p<0.002）。在调整其他协变量后的多变量逻辑分析中，TyG及其修正指数，包括TyG-WC、TyG-BMI均被证明与CSFP独立相关。进一步的受试者工作特征（ROC）曲线表明，与其他指数相比，TyG-WC在预测CSFP方面表现最佳。亚组分析显示，TyG-WC在CSFP中的预测价值在不同亚组中是一致的，只是在男性患者中的预测价值优于女性患者。
我们的研究表明，TyG、TyG-WC和TyG-BMI是CSFP的独立危险因素。在预测CSFP方面，TyG-WC比其他指数表现出更好的预测性能。
