Research Progress on Metabolic Inflammatory Markers and Coronary Artery Lesions in the Elderly

The triglyceride-glucose index (TyG), atherogenic index of plasma (AIP), and systemic immune-inflammation index (SII) can be calculated from routine laboratory measurements and characterize interrelated aspects of glucose-lipid metabolism, atherogenic lipid phenotype, and immune-inflammatory status.This narrative review summarizes clinical evidence on their associations with coronary artery lesion severity, with particular attention to applicability in older patients.Evidence is derived mainly from observational studies in general adult populations and suggests associations with prevalent coronary artery disease, Gensini scores, or other imaging outcomes.Some combined models show discriminatory ability; however, performance in predicting prognostic events does not establish their value for assessing anatomical lesion severity.Studies specifically involving older patients are limited and differ in age definitions, disease stages, outcome thresholds, and validation methods.Shared triglyceride information between TyG and AIP, potentially nonlinear SII associations, and the influence of non-coronary conditions further limit transportability of these indices and their thresholds.Future studies should define the target population and outcome, assess incremental value beyond traditional risk factors and the original component measurements, and conduct external validation.Three indicators can serve as supplementary reference information for cardiovascular risk assessment in elderly patients.