Comparison of TyG and modified TyG indices in predicting coronary slow flow phenomenon

BACKGROUND: The coronary slow flow phenomenon (CSFP) represents a common condition in patients with ischemia and non-obstructive coronary artery disease (INOCA). The triglyceride-glucose index (TyG) and relative modified indices have been established to be associated with CSFP. However, comparison of the clinical value of TyG and its modified indices in predicting CSFP has not been evaluated. MATERIALS AND METHODS: INOCA patients were retrospectively enrolled. According to the corrected TIMI counts, the patients were divided into the CSFP group and the non-CSFP group. A total of 4,627 patients were enrolled in our study. Among them, 69 patients were divided into the CSFP group, while 586 patients were divided into the non-CSFP group. Demographic, clinical risk factors, and laboratory results, including TyG and its modified indices, were compared between the two groups. The prognostic value of TyG and its modified indices in CSFP was compared using the area under the curve (AUC). RESULTS: Most of the demographic and clinical risk factors between CSFP patients and non-CSFP patients were comparable. For patients with CSFP, the patients were more likely to have chronic kidney disease (CKD) (39.13% vs. 20.31%, p < 0.001) and less likely to have anti-diabetic therapy (14.49% vs. 27.13%, p = 0.023). The patients with CSFP also had higher body weight index (BMI) (p < 0.001), higher levels of uric acid (UA), triglyceride (TG) (p = 0.017), total cholesterol (TC) (p = 0.016) and low-density lipoprotein cholesterol (LDL-C) (p = 0.006), homocysteine (p < 0.001) and uric acid (p < 0.002). Both TyG and its modified indices, including TyG-WC, TyG-BMI were demonstrated to be independently associated with CSFP in multi-variable logistic analysis after adjusting other co-variables.Further receiver operating characteristic (ROC) curve demonstrated that TyG-WC showed the best performance in predicting CSFP compared with other indices. Subgroup analysis revealed that the predictive value of TyG-WC in CSFP was consistent in different subgroups except that the predictive value was better in male patients compared with female patients, CONCLUSIONS: Our investigation reveals that TyG, TyG-WC and TyG-BMI were independent risk factors for CSFP. TyG-WC showed a better predictive performance than other indices in predicting CSFP.