Novel cardiometabolic indices and coronary microvascular dysfunction in intermediate stenosis: the role of AIP and TyG index

Background The study was designed to assess the association between two emerging cardiometabolic indices—the atherogenic index of plasma (AIP) and the triglyceride-glucose (TyG) index―and coronary microcirculation in patients with intermediate stenosis. Methods This cross-sectional study included 566 consecutive patients with intermediate coronary stenosis from a tertiary hospital between January 2023 and February 2024. Coronary microvascular dysfunction (CMD) was defined as an angiography-derived index of microcirculatory resistance (AMR) of ≥ 2.5. The AIP and TyG index were calculated from baseline laboratory data. All participants were categorized into tertiles based on each index. Results A total of 407 (71.9%) patients were diagnosed with CMD. Restricted cubic spline analysis showed a linear association of both the AIP and TyG index with CMD. Multivariate logistic regression revealed that individuals in the highest tertile of each index had a significantly greater risk of CMD than did those in the lowest tertile (AIP: OR = 2.17, 95% CI = 1.32–3.57, P = 0.002; TyG index: OR = 2.09, 95% CI = 1.27–3.46, P = 0.004). Subgroup analyses indicated a more pronounced relationship between AIP and CMD in the non-hypertension subgroup (P for interaction = 0.004). Receiver operating characteristic curve analysis demonstrated that the AIP had a higher area under the curve than the TyG index, with an optimal cutoff value of 0.152. Conclusion In patients with intermediate coronary stenosis, elevated AIP and TyG index were positively associated with an increased risk of CMD. AIP showed a modest advantage over the TyG index in predicting CMD.Association of AIP and TyG with CMDSubgroup Analysis of AIP and TyG for CMD Risk