The Correlation between the Triglyceride-Glucose Index and Coagulation Markers in Patients with Recent Acute Myocardial Infarction

Background. Metabolic abnormalities and hypercoagulability seem to have an important predictive role in patients with coronary artery disease (CAD). The triglyceride-glucose (TyG) index has emerged as a good marker for metabolic syndrome with predictive value for cardiovascular events. Overall haemostatic potential (OHP) is a reliable global haemostatic essay to identify hypercoagulability in CAD patients. The aim of our study was therefore to evaluate a possible correlation between the TyG index and haemostatic derangements in patients with CAD. Methods. Consecutive patients referred for the first follow-up visit after acute myocardial infarction between December 1, 2018, and March 31, 2020, and did not meet exclusion criteria were included. We determined OHP, overall coagulation potential (OCP), overall fibrinolytic potential (OFP), fibrinogen, D-dimer, and von Willebrand factor from peripheral blood samples. The TyG index was calculated with the previously described and validated formula. Linear regression models were constructed for the multivariate analysis. Results. A total of 117 patients (mean age <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mn>56</a:mn> <a:mo>±</a:mo> <a:mn>10</a:mn> </a:math> years, 20% women) were included. A correlation was found between TyG index and OCP ( <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mi>r</c:mi> <c:mo>=</c:mo> <c:mn>0.229</c:mn> <c:mo>,</c:mo> <c:mi>p</c:mi> <c:mo>=</c:mo> <c:mn>0.026</c:mn> </c:math> ), TyG index and OHP ( <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"> <e:mi>r</e:mi> <e:mo>=</e:mo> <e:mn>0.202</e:mn> <e:mo>,</e:mo> <e:mi>p</e:mi> <e:mo>=</e:mo> <e:mn>0.050</e:mn> </e:math> ), and TyG index and fibrinogen ( <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"> <g:mi>r</g:mi> <g:mo>=</g:mo> <g:mn>0.271</g:mn> <g:mo>,</g:mo> <g:mi>p</g:mi> <g:mo>=</g:mo> <g:mn>0.005</g:mn> </g:math> ). In the multivariate model which accounted for sex, age, and BMI, the correlation between TyG index and OCP ( <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M5"> <i:msup> <i:mrow> <i:mi>R</i:mi> </i:mrow> <i:mrow> <i:mn>2</i:mn> </i:mrow> </i:msup> </i:math> 0.108; ANOVA for regression <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M6"> <k:mi>p</k:mi> <k:mo>=</k:mo> <k:mn>0.035</k:mn> </k:math> ; beta 2.08 [0.79-4.01], <m:math xmlns:m="http://www.w3.org/1998/Math/MathML" id="M7"> <m:mi>p</m:mi> <m:mo>=</m:mo> <m:mn>0.042</m:mn> </m:math> ) and between TyG index and fibrinogen ( <o:math xmlns:o="http://www.w3.org/1998/Math/MathML" id="M8"> <o:msup> <o:mrow> <o:mi>R</o:mi> </o:mrow> <o:mrow> <o:mn>2</o:mn> </o:mrow> </o:msup> </o:math> 0.11; ANOVA for regression <q:math xmlns:q="http://www.w3.org/1998/Math/MathML" id="M9"> <q:mi>p</q:mi> <q:mo>=</q:mo> <q:mn>0.015</q:mn> </q:math> ; beta 0.35 [0.08-0.62], <s:math xmlns:s="http://www.w3.org/1998/Math/MathML" id="M10"> <s:mi>p</s:mi> <s:mo>=</s:mo> <s:mn>0.012</s:mn> </s:math> ) emerged as statistically significant. Conclusion. The TyG index, a marker of metabolic syndrome, has a strong correlation with a hypercoagulability state in CAD, as determined by the OCP and higher fibrinogen levels. Our findings suggest that metabolic syndrome may be an important driver of atherothrombotic risk in patients with CAD.