OBJECTIVE

This study aimed to investigate the relationship between the triglyceride-glucose (TyG) index and the presence of severe left main and/or three-vessel disease (LM/3VD) evaluated by SYNTAX score.

DESIGN

Cross-sectional study.

SETTING

Shenzhen Nanshan People's Hospital and The First Affiliated Hospital of Jinan University.

PARTICIPANTS

596 patients were first diagnosed with non-ST-segment elevation myocardial infarction (NSTEMI).

PRIMARY OUTCOME MEASURES

Incidence of severe LM/3VD and the relations between the TyG index and the severe LM/3VD evaluated by SYNTAX score.

RESULTS

After fully adjusting for confounders, the TyG index was a significant independent predictor for severe coronary artery disease (CAD) (OR 1.744; 95% CI 1.166 to 2.609; p 0.007). The TyG and severe CAD were found to be linearly correlated using the restricted cubic splines (p for non-linearity=0.161). The TyG demonstrated a consistent association with severe CAD across different subgroups, such as individuals with and without diabetes, hypertension, hyperlipidaemia and different haemoglobin (<6.5 or ≥6.5). No statistically significant interaction was detected within the subgroup (p > 0.05). In comparison to risk factors based solely on age or ST-elevation in lead Augmented Unipolar Right-arm (aVR), the area under the curve value for the prediction of severe CAD was modestly improved to 0.759 by the addition of the TyG.

CONCLUSION

Patients with NSTEMI demonstrated that a positive relationship was found between a higher level of TyG and an increased level of coronary anatomical complexity (LM/3VD with SYNTAX score >22). The TyG could serve as a non-invasive marker for predicting severe CAD and have implications for guiding treatment strategies in patients with NSTEMI.