Predictive value of triglyceride-glucose index combined with low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio for acute coronary syndrome and extent of coronary artery disease

LI Xue-ya; WEN Xiang; YANG Li; YANG Yu; JING Wei; ZHANG Jing

doi:10.3969/j.issn.1672-5301.2025.01.003

Abstract：Objective To investigate the predictive value of triglyceride-glucose index(TyG index)combined with low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio(LDL-C/HDL-C)for acute coronary syndromes(ACS)and the degree of coronary artery lesions.Methods The clinical data of 245 patients who were admitted to the Department of Cardiology of the Second People's Hospital of Hefei City and underwent coronary angiography(CAG)due to chest tightness and chest pain from September 2020 to September 2023 were retrospectively analyzed;the patients diagnosed with ACS were set up as the ACS group(n=204),but the patients with coronary heart disease excluded by coronary angiography during the same period were set up as the normal group(n=41);and the ACS group was further divided into two subgroups by the Gensini score,with 64 cases in the subgroup of mild-to-moderate coronary artery lesions(Gensini score<35)and 140 cases in the subgroup of severe coronary artery lesions(Gensini score≥35).The TyG index and LDL-C/HDL-C ratio were compared between the ACS group and the normal group;the TyG index and LDL-C/HDL-C ratio were compared between the subgroup with severe coronary lesions and the subgroup with mild to moderate coronary lesions.The multifactorial Logistic regression analysis was used to analyze the influencing factors of ACS and ACS patients with severe coronary lesions.The Pearson correlation analysis was used to analyze the correlation between TyG index and LDL-C/HDL-C and Gensini score.ROC curve analysis was performed to assess the value of TyG index combined with LDL-C/HDL-C ratio in diagnosing the occurrence of severe coronary lesions in ACS and ACS patients.Results The multifactorial Logistic regression analysis showed that both TyG index and LDL-C/HDL-C ratio were the independent risk factors for severe coronary artery lesions in ACS and ACS patients(P<0.01).The Pearson correlation analysis showed that there was a positive correlation between TyG index and LDL-C/HDL-C ratio and the Gensini score in ACS patients(r=0.390,P<0.01;r=0.396,P<0.01).ROC curve analysis showed that the AUCs of TvG index,LDL-C/HDL-C ratio and the combination of the two for diagnosis of ACS were 0.788,0.797 and 0.843(P<0.01),and those for diagnosis of severe coronary artery lesions were 0.753,0.765,and 0.817(P<0.01).Conclusion Elevated TyG index and LDL-C/HDL-C ratio have certain diagnostic value for ACS and severe coronary artery lesions in ACS patients,and the combined diagnostic value of the two is better than that of either single index,which is of clinical value for the identification of ACS and the prediction of severe coronary artery lesions in ACS patients.