Association between Triglyceride-glucose index and coronary artery in-stent restenosis: A case-control study in an Iranian patient population.

Background: The Triglyceride-glucose (TyG) index, a useful surrogate marker of insulin resistance (IR), is associated with cardiovascular disease (CVD). However, the correlation between the TyG index and coronary in-stent restenosis (ISR) remains unknown.

Methods: A total of 325 subjects who underwent coronary angiography due to acute coronary syndrome (ACS) ≥ 1 month after stent implantation were included in this retrospective case-control study from December 2014 to April 2017. Based on ISR status (≥ 50% stenosis), 111 patients were assigned to the ISR group and 214 to the non-ISR (NISR) group. Baseline characteristics and biochemical data were gathered. Logistic regression (LR) analysis was used to evaluate the predictive value of the TyG index for ISR with different models. P < 0.05 was considered statistically significant.

Results: The TyG index was significantly higher among patients with ISR compared with NISR patients (8.84 ± 0.85 vs. 8.61 ± 0.63; P = 0.010). The TyG index remained an independent predictor for ISR in all multivariable LR analysis models, with the fully adjusted model demonstrating the strongest relation (OR = 2.239; 95% CI: 1.325-3.782; P = 0.003). Furthermore, the risks for ISR were almost 5-fold greater in patients in the highest TyG quartile than in those in the lowest quartile (95% CI: 1.718-14.454; P = 0.003).

Conclusion: An elevated TyG index is independently linked with ISR. Consequently, the TyG index acts as a simple and pivotal marker for identifying patients at higher risk of ISR and for evaluating adverse cardiovascular outcomes.