Key result
An elevated triglyceride glucose index independently predicted coronary artery calcification progression in asymptomatic low-risk adults, with each unit increase associated with an odds ratio of 1.57.
Why the study?
The role of the triglyceride glucose index in coronary artery calcification progression had not been extensively assessed, particularly in a low-risk population.
Does a higher triglyceride glucose (TyG) index predict coronary artery calcification progression in asymptomatic low-risk adults?
Observational (n=5,775)
Yes
Does a higher triglyceride glucose (TyG) index predict coronary artery calcification progression in asymptomatic low-risk adults?
Odds Ratio: 1.57 (95% CI 1.33–1.81)
Absolute Event Rate: 31.3% vs 17.6%
p-value: p=<0.001
The triglyceride glucose index is an independent predictor of coronary artery calcification progression and adds incremental risk stratification over baseline CACS in asymptomatic low-risk individuals.
May refine CAC risk stratification in low-risk adults; hypothesis-generating and requires prospective trials before clinical adoption.
BACKGROUND: The triglyceride glucose (TyG) index has been suggested as a reliable surrogate marker of insulin resistance which is a substantial risk factor for atherosclerotic cardiovascular disease (ASCVD). Several recent studies have shown the relationship between the TyG index and cardiovascular disease; however, the role of the TyG index in coronary artery calcification (CAC) progression has not been extensively assessed especially in low-risk population. METHODS: We enrolled 5775 Korean adults who had at least two CAC evaluations. We determined the TyG index using ln (fasting triglycerides [mg/dL] x fasting glucose [mg/dL]/2). The CAC progression was defined as either incident CAC in a CAC-free population at baseline or an increase of ≥ 2.5 units between the square roots of the baseline and follow-up coronary artery calcium scores (CACSs) of subjects with detectable CAC at baseline. RESULTS: CAC progression was seen in 1,382 subjects (23.9%) during mean 3.5 years follow-up. Based on the TyG index, subjects were stratified into four groups. Follow-up CACS and incidence of CAC progression were markedly elevated with rising TyG index quartiles (group I [lowest]:17.6% vs. group II:22.2% vs. group III:24.6% vs. group IV [highest]: 31.3%, p < 0.001). In multivariate logistic regression analysis, the TyG index was independent predictor of CAC progression (odds ratio: 1.57; 95% confidence interval: 1.33 to 1.81; p < 0.001) especially in baseline CACS ≤ 100 group. CONCLUSION: The TyG index is an independent predictor of CAC progression in low-risk population. It adds incremental risk stratification over established factors including baseline CACS.
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Song et al. (2022) conducted an observational in Asymptomatic low-risk population for atherosclerotic cardiovascular disease (n=5,775). Triglyceride glucose (TyG) index vs. Lower TyG index quartiles was evaluated on Coronary artery calcification (CAC) progression (OR 1.57, 95% CI 1.33-1.81, p=<0.001). An elevated triglyceride glucose index independently predicted coronary artery calcification progression in asymptomatic low-risk adults, with each unit increase associated with an odds ratio of 1.57.
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