Association of the triglyceride glucose-body mass index with the extent of coronary artery disease in patients with acute coronary syndromes: a retrospective cohort study

Abstract

Abstract Background Studies have shown that insulin resistance is strongly associated with the development of cardiovascular disease, and the triglyceride glucose-body mass index (TyG-BMI index) is considered to be a reliable surrogate marker of insulin resistance. There are limited studies on the relationship between TyG-BMI index and the extent of coronary artery disease in patients with acute coronary syndrome (ACS). The aim of this study was to investigate the relationship between TyG-BMI index and the extent of coronary artery disease in patients with ACS. Methods Overall, 2,317 patients with ACS who underwent percutaneous coronary intervention at the Affiliated Hospital of Zunyi Medical University were included in this study. The TyG-BMI index was grouped according to the tertile method. The extent of coronary artery disease in patients with ACS was quantitatively assessed using the SYNTAX score, which was categorised as low (≤ 22), intermediate (23–32), and high risk (≥ 33). Results Both univariate and multivariate logistic regression analyses showed no statistically significant association between TyG-BMI index and moderate/high SYNTAX scores in patients with ACS. Subgroup analyses showed that in one-way logistic regression analyses, TyG-BMI index was associated with a high risk of moderate/high SYNTAX scores in female patients [odds ratio (OR) = 1.0076; 95% confidence interval (CI) = 1.0014–1.0138; P = 0.0160)], and the last tertile group (OR = 2.1100; 95% CI = 1.1200–3.9800; P = 0.0220) had a 2.11 times higher risk of having a moderate/high SYNTAX score than the first tertile group. Restricted cubic spline analysis showed a linear correlation between TyG-BMI index and complex coronary artery disease (SYNTAX score > 22) in female patients with ACS. In these patients, the inclusion of the TyG-BMI index provided limited improvement in the predictive power of the baseline risk model. Conclusions Higher TyG-BMI index was linearly associated with the risk of developing complex coronary lesions in female patients with ACS. However, the inclusion of TyG-BMI index provided limited improvement in the predictive power of the baseline risk model for female patients with ACS.