Triglyceride glucose index is associated with functional coronary artery stenosis in hypertensive patients

Background The triglyceride glucose (TyG) index is an effective method for determining insulin resistance (IR). Limited research has explored the connection between the TyG index and functionally significant stenosis in hypertensive patients. Furthermore, the connections between the TyG index, fat attenuation index (FAI) and atherosclerotic plaque characteristics are also worth exploring. Methods The study screened 1622 hypertensive participants without coronary artery disease history who underwent coronary computed tomography angiography. The TyG index was calculated as ln (fasting glucose mg/dL * fasting TG mg/dL/2). Adverse plaque characteristics (HRPCs), high-risk plaques (HRPs), FAI, and CT-derived fractional flow reserve (FFR CT ) were analyzed and measured for all patients. Functionally significant stenosis causing ischemia is defined as FFR CT ≤ 0.80. Two patient groups were created based on the FFR CT : the FFR CT 0.80 group and the FFR CT 0.80 group. In hypertensive patients, the association between the TyG index and FFR CT was examined applying a logistic regression model. Results The TyG index was higher for people with FFR CT ≤ 0.80 contrast to those with FFR CT 0.80. After controlling for additional confounding factors, the logistic regression model revealed a clear connection between the TyG index and FFR CT ≤ 0.80 (OR = 1.718, 95% CI 1.097–2.690, p = 0.018). The restricted cubic spline analysis displayed a nonlinear connection between the TyG index and FFR CT ≤ 0.80 ( p for nonlinear = 0.001). The TyG index increased the fraction of individuals with HRPs and HRPCs, FAI raised, and FFR CT decreased ( p 0.05). The multivariate linear regression analysis illustrated a powerfulcorrelation between high TyG index levels and FAI, FFR CT , positive remodeling (PR), and low-attenuation plaque (LAPs) (standardized regression coefficients: 0.029 p = 0.007, -0.051 p 0.001, 0.029 p = 0.027, and 0.026 p = 0.046, separately). Conclusion In hypertensive patients, the TyG index showed an excellent association with a risk of FFR CT ≤ 0.80. Additionally, the TyG index was also linked to FAI, FFR CT , PR, and LAPs.