What is the clinical evidence from this study?

Study design: Case-Control. Population: Coronary slow flow (n=144). Intervention: Triglyceride glucose index vs. Normal coronary flow. Primary outcome: Risk of coronary slow flow (OR 7.459, p=0.0001).

January 1, 2022Open Access

Assessment of triglyceride/glucose index with respect to coronary slow flow

IBIpek BUBERPamukkale University RNRukiye NarUniversity of Florida Health DKDerya KayaDokuz Eylül University

Resultado clave

The triglyceride glucose index was independently associated with an increased risk of coronary slow flow (OR 7.459, p=0.0001).

Diseño del estudio

Tipo

Case-Control (n=144)

Multicéntrico

PICO estructurado

Is the triglyceride glucose index associated with the presence of coronary slow flow in patients undergoing coronary angiography for chest pain?

Población

144 patients who underwent coronary angiography for chest pain, comprising 72 with coronary slow flow and 72 demographically similar controls.

Exposición

Higher Triglyceride Glucose Index (TGI)

Comparador

Lower TGI / patients without coronary slow flow (control group)

Resultado

Presence of coronary slow flow (CSF) and its correlation with TIMI frame count (TFC)surrogate

The triglyceride glucose index, a marker of insulin resistance, is independently associated with the presence of coronary slow flow in patients undergoing angiography.

Resultado numérico

Odds Ratio: 7.459

Tasa de eventos absoluta: 9.26% vs 9.02%

valor p: p=0.0001

Limitaciones

Retrospective study design does not allow for evaluation of cause-effect relationship.
Does not supply prognostic data for future cardiovascular events.
Triglyceride and fasting glucose measurements have intra-individual biological variation.
Did not evaluate relationship between TGI and all metabolic factors such as BMI, waist circumference, and HOMA-IR.

Resumen

BACKGROUND: Coronary slow flow (CSF) is determined by delayed opacification of the epicardial coronary arteries without obstructive disease. The triglyceride glucose index (TGI) has been suggested as a useful marker of insulin resistance. Previous studies have shown that TGI is associated with cardiovascular disease, but no study has examined the relationship between TGI and CSF. OBJECTIVES: Therefore, the primary objective of the present study was to investigate the relationship between TGI and CSF. METHODS: This study retrospectively evaluated patients who were admitted to our clinic with complaints of chest pain and underwent coronary angiography between January and December 2018. A total of 1100 coronary angiography images were assessed, and 72 patients with CSF were detected. Coronary flow was quantified objectively using the TIMI (thrombolysis in myocardial infarction) frame count (TFC) method as described by Gibson et al. TGI was calculated as follows: ln fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2. RESULTS: The CSF group had significantly higher glucose levels (mg/dl) (114.92±30.92), (125.61±33.22), than the control and CSF groups, respectively, p=0.0001, TGI (9.02±0.56), (9.26±0.54), p=0.0001, and triglyceride levels (mg/dl) (170.67±110.81), (201.19±136.93), p=0.002. There was no statistically significant correlation between TGI and left anterior descending artery TFC, circumflex artery TFC, right coronary artery TFC (r/p values; 0.24/0.06; 0.32/0.08; 0.18/0.36, respectively). TGI, HDL, HT, age, and sex were examined with a multiple logistic model, and TGI was found to be statistically significant for the risk of CSF (p=0.0001; O.R:7.459). CONCLUSION: TGI was statistically significantly higher in the CSF group than the control group. According to the multivariate logistic regression analysis, only TGI was independently associated with the risk of CSF, but higher TGI did not predict more slow coronary flow. Prospective studies are needed to clarify the prognostic relationship of TGI and CSF in terms of future cardiovascular events (Tab. 2, Fig. 1, Ref. 19).

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