October 29, 2025Frontiers in Cardiovascular Medicine1 citationsOpen Access

Combined predictive value of triglyceride-glucose index and remnant cholesterol for coronary artery disease in young adults

XWXi WuXiangyang Central Hospital MWMingxin WuXiangyang Central Hospital HHHaobo HuangHunan University

Structured PICO

Do the triglyceride-glucose index and remnant cholesterol predict the presence and severity of coronary artery disease in young adults?

Population

458 patients aged ≤45 years who underwent coronary angiography for evaluation of chest pain or tightness. Exclusions included prior MI, PCI, CABG, structural cardiac abnormalities, significant hepatic/renal impairment, recent lipid-lowering therapy, known hyperlipidemia, and history of diabetes with well-controlled FBG/HbA1c.

Intervention

Assessment of triglyceride-glucose (TyG) index and remnant cholesterol (RC) levels

Comparator

Normal coronary angiography findings (for CAD prediction) and single-vessel disease (for multi-vessel disease prediction)

Outcome

Presence of coronary artery disease (CAD) and multi-vessel disease (MVD) as determined by coronary angiographysurrogate

The triglyceride-glucose index and remnant cholesterol are independent, complementary biomarkers that can enhance early risk stratification for coronary artery disease and multi-vessel involvement in young adults.

Abstract

Introduction: Coronary artery disease (CAD) is increasingly prevalent in individuals aged ≤45 years, yet effective early detection strategies remain lacking. Insulin resistance (IR) and remnant cholesterol (RC) burden are critical contributors to early atherosclerosis, highlighting the potential utility of novel markers such as the triglyceride-glucose (TyG) index and RC. Methods: In this retrospective study, we analyzed 458 patients aged ≤45 years who underwent coronary angiography (CAG). The TyG index and RC were calculated using standard fasting plasma glucose (FPG) and lipid profiles. Participants were classified into normal coronary, CAD, single-vessel disease (SVD), and multi-vessel disease (MVD) groups. Logistic regression analysis was performed to identify independent predictors of CAD and MVD. Receiver operating characteristic (ROC) curves were used to evaluate the discriminative ability of TyG and RC. Results: < 0.001), and further elevated in those with MVD. In multivariate analysis, TyG (odds ratio OR = 1.393) and RC (OR = 1.475) were independently associated with CAD and also predicted MVD (TyG OR = 2.363; RC OR = 3.692). RC had a higher area under the curve (AUC) for identifying CAD than TyG (0.773 vs. 0.669), whereas TyG had greater predictive value for MVD (AUC = 0.775 vs. 0.683). Discussion: The TyG index and RC are independent, complementary, and accessible biomarkers for assessing early CAD risk in young adults. RC showed higher sensitivity in identifying the presence of CAD, while higher TyG index values were associated with multi-vessel involvement. Incorporating these markers into screening protocols may enhance early risk stratification and help prevent premature atherosclerosis in young populations.

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