Association of the TyG index and inflammatory burden index with AMR-defined coronary microvascular dysfunction and 12-month MACE after STEMI

Figures

• 

  Figure 1. Study flowchart.

• 

  Figure 2. Distribution of the TyG index (A) and IBI (B) in patients with and without CMD.

• 

  Figure 3. RCS analyses of the associations of TyG (A) and IBI (B) with the risk of CMD in the fully adjusted model. Solid lines represent adjusted odds ratios and shaded areas indicate 95% confidence intervals.

• 

  Figure 4. ROC curves of the TyG index, IBI, and the combined model for identifying CMD.

• 

  Figure 5. Decision curve analysis of the TyG index, IBI, and the combined model for predicting CMD.

• 

  Figure 6. Discrimination and internally validated calibration of sequential models for identifying AMR-defined coronary microvascular dysfunction. (A) Receiver operating characteristic curves for Models (A–C). (B) Calibration curves derived from 1,000 bootstrap resamples; the 45° dashed line indicates perfect agreement between predicted and observed probabilities. Brier scores shown in panel (B) are apparent-sample estimates. Model A included age, Killip class ≥II, door-to-balloon time, left anterior descending artery as the culprit vessel, and high thrombus burden; Model B added the TyG index; and Model C further added IBI. AUC, area under the receiver operating characteristic curve; CMD, coronary microvascular dysfunction; IBI, inflammatory burden index; TyG, triglyceride-glucose index.

• 

  Figure 7. Subgroup analyses of the associations of the TyG index and IBI with AMR-defined coronary microvascular dysfunction. (A) TyG index per 1-unit increase. (B) IBI per 10-unit increase. Squares and horizontal lines represent odds ratios and 95% confidence intervals. Interaction P values were obtained from multiplicative interaction terms. Coding: gender, 0 = female and 1 = male; diabetes, 0 = no and 1 = yes; pre-PPCI TIMI flow 0–1, 0 = TIMI grade 2–3 and 1 = TIMI grade 0–1; Killip class ≥II, 0 = class I and 1 = class ≥II. P values are for interaction.

• 

  Figure 8. Kaplan–Meier curves for 12-month MACE in patients stratified by CMD status (A) and by combined TyG/IBI categories (B). CMD, coronary microvascular dysfunction; IBI, inflammatory burden index; MACE, major adverse cardiovascular events; TyG, triglyceride-glucose index.

• 

  Figure 9. Proposed metabolic–inflammatory framework linking TyG, IBI, AMR-defined coronary microvascular dysfunction, and 12-month MACE after STEMI.