Abstract
BackgroundRecent studies have substantiated the role of the triglyceride glucose (TyG) index in predicting the prognosis of coronary artery disease (CAD) patients, while no relevant studies have revealed the association between the TyG index and coronary collateralization in the event of coronary chronic total occlusion (CTO). The current study intends to explore whether, or to what extent, the TyG index is associated with impaired collateralization in CAD patients with CTO lesions.MethodsThe study enrolled 1093 CAD patients undergoing cardiac catheterization for at least one CTO lesion. Data were collected from the Beijing Anzhen Hospital record system. The degree of collaterals was determined according to the Rentrop classification system. The correlation between the TyG index and coronary collateralization was assessed.ResultsOverall, 318 patients were included in a less developed collateralization (Rentrop classification 0-1) group. The TyG index was significantly higher in patients with impaired collateralization (9.3±0.65 vs. 8.8±0.53, P<0.001). After adjusting for various confounding factors, the TyG index remained correlated with the occurrence of impaired collateralization, with odds ratios (ORs) of 1.59 and 5.72 in the T2 and T3 group compared with the first tertile group (P<0.001). In addition, subgroup analysis showed that higher TyG index values remained strongly associated with increased risk of less developed collateralization. To compare the risk assessment efficacy for the formation of collateralization between the TyG index and other metabolic abnormality indicators, an area under the receiver-operating characteristic (ROC) curve (AUC) was obtained. A significant improvement in the risk assessment performance for impaired collateralization emerged when adding the TyG index into a baseline model.ConclusionsThe increased TyG index is strongly associated with less developed collateralization in CAD patients with CTO lesions and its risk assessment performance is better than single metabolic abnormality indicators.
Highlights
coronary artery disease (CAD) refers to the accumulative process of atherosclerotic plaques in the epicardial arteries and is a major cause of death worldwide
Coronary angiographic analysis indicated that the incidences of chronic total occlusion (CTO) in the right coronary artery (RCA), left circumflex artery (LCX) and left anterior artery (LAD) were 48 %, 18 % and 34 % respectively, with a difference of P=0.078 between two groups
The distribution of number of the diseased vessels shows no significantly different (P=0.912). It seems that RCArelated CTO lesions tended to be well developed (P= 0.054), while CTO lesions located in Left anterior descending artery (LAD) were likely to be less developed (P=0.035); Notably, the rate of impaired collateralization seemed to be higher in patients whose CTO lesions caused by In-Stent Restenosis (ISR) (P=0.140)
Summary
CAD refers to the accumulative process of atherosclerotic plaques in the epicardial arteries and is a major cause of death worldwide. The application of invasive strategies, such as percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) and antithrombotic treatments, has greatly decreased the in-hospital major adverse cardiovascular events (MACEs) and mortality rates [1,2,3]. Studies have shown the protective role of well-developed coronary collateralization in improving the survival and prognosis of patients with CAD [9, 10]. Recent studies have substantiated the role of the triglyceride glucose (TyG) index in predicting the prognosis of coronary artery disease (CAD) patients, while no relevant studies have revealed the association between the TyG index and coronary collateralization in the event of coronary chronic total occlusion (CTO). The current study intends to explore whether, or to what extent, the TyG index is associated with impaired collateralization in CAD patients with CTO lesions
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