Impact of Triglycerides Glucose Index on Angiographic Profiling of Non-Diabetic Premature Coronary Artery Disease Patients

Background: The triglyceride–glucose (TyG) index serves as a straightforward marker for assessing insulin resistance that may unmask metabolically high-risk individuals; its relationship with angiographic disease burden and lesion complexity in non-diabetic premature coronary artery disease (CAD) remains incompletely defined.Aim: This work assessed the TyG index impact on coronary angiographic profiling in non-diabetic patients with premature CAD.Patients and Methods: One hundred eighty non-diabetic adults with angiographically confirmed premature CAD were enrolled and dichotomized at the cohort median TyG into low TyG index (n=100) and high TyG index(n=80) groups; angiographic burden and lesion complexity (SYNTAX) were compared.Results: All-cause mortality exhibited comparability between both TyG and SYNTAX groups. Non-fatal myocardial infarction exhibited comparability across both subgroups, whereas ischemia-driven revascularization occurred significantly more often in the high TyG index (P < 0.05) and high SYNTAX (P = 0.04) groups. Correlation analysis demonstrated that the TyG index correlated positively with dyslipidemia, triglycerides, LDL-C, total cholesterol, and uric acid, and inversely with HDL-C (r = 0.180, 0.815, 0.345, 0.746, 0.562, −0.482; P = 0.015, <0.001, <0.001, <0.001, <0.001, <0.001, respectively).Conclusions: In non-diabetic premature CAD, a higher TyG index identifies a metabolically adverse phenotype associated with more extensive and complex coronary disease and a higher need for revascularization. TyG may offer an inexpensive risk-stratification tool in this population.