Abstract 13925: Initial Triglyceride Glucose Index as a Predictor of No-Reflow After Primary Percutaneous Coronary Intervention

Abstract

Introduction: The triglyceride glucose (TyG) index is a screening method for insulin resistance that can be used on a daily clinical basis and only requires two laboratory determinations: serum triglycerides and serum glucose. Prospective studies of predictive values of the TyG index for cardiovascular diseases (CVD) have primarily focused on pre-existing coronary arterial disease or diabetes mortality, and the TyG index has been shown to be associated with subclinical atherosclerosis symptoms, such as arterial stiffness and preclinical coronary arterial calcification. The study aimed to investigate the possible correlation between the TyG index and the no-reflow phenomenon in patients presented with acute STEMI undergoing primary percutaneous coronary intervention (PPCI). Methods: A total number of 702 patients who presented with acute STEMI in the period from 1/9/2015 to 1/9/2019 who underwent PPCI according to the standard techniques were included. Patients with a previous history of diabetes, dyslipidemia, or on statin therapy were excluded from the study. Initial triglyceride levels as well as fasting blood glucose were tested in all patients at the time of admission. TyG index was calculated for all patients. No-reflow was defined as distal Thrombolysis in Myocardial Infarction (TIMI) flow less than III. Results: 618 patients (88 %) had normal flow while 84 patients (12%) had no-reflow. The mean TyG index was 4.3±0.4 in the no-reflow group versus 4.2±0.4 in the normal reflow group (P = 0.03). After propensity matching, the mean TyG index was 4.2 ± 0.3 in both groups. (P = 0.99) Conclusion: In a retrospective observational study, there was no statistically significant difference between no-reflow and normal flow groups after propensity matching. Further research is required to detect whether the TyG index can be used as a readily available independent predictor of cardiovascular morbidity and mortality.