This single-center cross-sectional study examined the relationship between the triglyceride–glucose (TyG) index and the severity of coronary artery disease as measured by the Gensini Score. A total of 861 patients with coronary heart disease who underwent coronary angiography between June 2022 and June 2024 at the Fourth Affiliated Hospital of Harbin Medical University were included. Patients were grouped by Gensini-derived stenosis severity (low, moderate, high). TyG differed significantly between mild and severe stenosis (p = 0.0021) and between moderate and severe stenosis (p = 0.0173). Treated as a continuous variable, TyG was associated with coronary stenosis (OR = 1.591; 95% CI: 1.237–1.866). After adjusting for age, sex, diabetes, and hypertension, higher TyG quartiles demonstrated increased odds for severe stenosis compared with the reference quartile. The authors conclude that the TyG index is positively associated with coronary stenosis burden and may serve as an indicator of atherosclerosis severity.
Cardiovascular disease is the leading global cause of death, and coronary heart disease (CHD) is the most common manifestation. Atherosclerosis underlies CHD and is linked to disturbances in glucose and lipid metabolism, endothelial dysfunction, and chronic vascular inflammation. The TyG index, calculated from fasting triglyceride and glucose measurements, has been proposed as a surrogate marker of insulin resistance and has been associated with cardiovascular events and mortality in prior large cohorts.
The Gensini Score is an angiographic scoring system that quantifies the severity and functional impact of coronary stenoses by integrating percent luminal narrowing with regional weighting factors. Despite evidence for TyG as a prognostic biomarker, the association between TyG and angiographic measures of stenosis severity has been insufficiently explored, prompting the present analysis.
Study design and setting: The analysis was a cross-sectional, observational study conforming to the Declaration of Helsinki. Consecutive adult patients (≥18 years) diagnosed with CHD who underwent coronary angiography at the Fifth Ward, Department of Cardiovascular Medicine, Fourth Affiliated Hospital of Harbin Medical University between June 2022 and June 2024 were considered.
Participants: The source reports inclusion of 861 CHD patients who underwent coronary angiography. Further inclusion/exclusion criteria, recruitment flow, and whether any patients were excluded or lost were not fully detailed in the provided extract.
Data collection: Demographic, clinical, and laboratory data were extracted from medical records. The TyG index was derived from fasting triglyceride and glucose values; the precise formula and laboratory assay methods are described in the full manuscript but were not reproduced in the provided source excerpt.
Coronary assessment: Coronary angiography results were quantified using the Gensini Score. Patients were divided into three groups representing low, moderate, and high stenosis severity based on GS thresholds; specific cutpoints for those groups were not specified in the extracted text.
Statistical analysis: Multivariate logistic regression was used to assess associations between the TyG index and coronary stenosis severity. TyG was analyzed both as a continuous variable and by quartiles. Models adjusted for at least age, sex, diabetes, and hypertension. Additional covariates and model diagnostics were not detailed in the provided excerpt.
Cohort: 861 patients with CHD who underwent coronary angiography between June 2022 and June 2024 were included.
TyG and stenosis severity: Median or mean TyG levels varied across Gensini-based stenosis groups. Statistically significant differences were observed between the mild and severe stenosis groups (p = 0.0021) and between the moderate and severe groups (p = 0.0173), indicating higher TyG values in patients with more severe angiographic disease.
Association estimates: When entered as a continuous predictor, the TyG index was significantly associated with coronary stenosis (OR = 1.591; 95% CI: 1.237–1.866). In adjusted analyses controlling for age, sex, diabetes, and hypertension, participants in higher TyG quartiles had increased odds of severe coronary stenosis compared with the reference quartile; the source reports adjusted ORs for the second, third, and fourth quartiles as 0.932 (95% CI: 0.642–1.351), 1.045 (95% CI: 0.691–1.581), and 1.101 (95% CI: 0.605–2.004), respectively. Some of these quartile-specific confidence intervals include 1.
Diagnostic combination with biomarkers: The authors report evaluating TyG’s diagnostic efficacy in combination with serum biomarkers; however, the specific biomarkers assessed, performance metrics (sensitivity, specificity, AUC), and numeric results were not reported in the provided text.
The study findings indicate a positive association between the TyG index and angiographic coronary stenosis burden as quantified by the Gensini Score. The results are consistent with prior literature linking TyG to cardiovascular events and with the concept that insulin resistance and dysregulated triglyceride metabolism contribute to atherosclerotic progression and plaque complexity.
Clinical implications: Elevation of TyG in patients with more severe stenosis suggests the index may provide incremental information about atherosclerotic burden beyond traditional risk factors. The authors suggest TyG could serve as a convenient, low-cost surrogate marker to assist risk stratification in patients with CHD.
Caveats: The cross-sectional design precludes causal inference. Although the analysis adjusted for several confounders (age, sex, diabetes, hypertension), residual confounding is possible. The provided extract does not include full model specifications, external validation, or longitudinal outcome data.
In this cohort of 861 CHD patients undergoing coronary angiography, higher TyG index values were associated with greater coronary stenosis severity by Gensini Score. The TyG index may reflect the extent of atherosclerosis and serve as an indicator of insulin resistance in CHD. Further research, including prospective and mechanistic studies and explicit reporting of diagnostic performance when combined with serum biomarkers, is needed to clarify clinical utility.
The published article includes figures and tables (Gensini-related analyses, distribution plots, and tabulated clinical/laboratory characteristics). Specific figure panels and table contents were not reproduced in full in the provided extract.