The clinical importance of triglyceride/glucose ratio in the primary prevention of cardiovascular diseases: A retrospective cohort study

Year 2021, Volume: 5 Issue: 10, 1020 - 1023, 01.10.2021

Uğur Küçük , Ali Duygu , Emine Gazi

https://doi.org/10.28982/josam.864108

Abstract

Background/Aim: Atherosclerosis plays a significant role in cardiovascular diseases. Dyslipidemia, inflammation, genetics, and environmental factors greatly impact the development and progression of atherosclerosis. This study aimed to investigate the importance of triglyceride-glucose ratio in primary cardiovascular event prevention.
Methods: Our retrospective cohort study included 56 patients (39 males, 17 females). Coronary computed tomography angiography (CCTA) images of the individuals were examined, and calcium score was calculated using the Agatston score. Those with a score of zero and those with scores>0 were included in Groups 1 and 2, respectively. Triglyceride/glucose (TyG) ratio and atherosclerotic cardiovascular disease (ASCVD) risk were calculated for all individuals.
Results: Among all patients, 69.6% had coronary artery calcium scores (CACs) of greater than zero. The TyG ratios were 0.92 (0.33) and 1.77 (0.83) in Groups 1 and 2, respectively (P<0.001). The ASCVD risk was 4.17 (4.92) in Group 1, and 16.24 (10.66) in Group 2 (P<0.001). The TyG ratio was positively correlated with calcium score and ASCVD risk (r=0.717, P<0.001 and r=0.456, P<0.001, respectively). TyG ratio (OR=33.132, 95% CI=4.404-249.254, P=0.001) predicted CACs in CTBA in the univariate logistic analysis. The cut-off level for the TyG ratio in the prediction of coronary atherosclerosis was 1.04, with a sensitivity of 74%, and a specificity of 88% (AUC=0.84, P<0.001).
Conclusion: The present study showed that the TyG ratio could assist the current risk assessment scores used for primary prevention in cardiovascular diseases.

Keywords

Cardiovascular diseases, Coronary calcium score, Prevention

References

• 1. Francula-Zaninovic S, Nola IA. Management of Measurable Variable Cardiovascular Disease' Risk Factors. Curr Cardiol Rev. 2018;14:153-63. PMID: 29473518.
• 2. Demer LL, Tintut Y. Vascular calcification: pathobiology of a multifaceted disease. Circulation 2008;117:2938–48. PMID: 18519861.
• 3. Nasir K, Bittencourt MS, Blaha MJ, Blankstein R, Agatson AS, Rivera JJ, et al. Implications of Coronary Artery Calcium Testing Among Statin Candidates According to American College of Cardiology/American Heart Association Cholesterol Management Guidelines: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol. 2015;66:1657-68. PMID: 26449135.
• 4. Tota-Maharaj R, Joshi PH, Budoff MJ, Whelton S, Zeb I, Rumberger J, et al. Usefulness of regional distribution of coronary artery calcium to improve the prediction of all-cause mortality. Am J Cardiol. 2015;115:1229-34. PMID: 25743208.
• 5. Hamilton-Craig CR, Chow CK, Younger JF, Jelinek VM, Chan J, Liew GY. Cardiac Society of Australia and New Zealand position statement executive summary: coronary artery calcium scoring. Med J Aust. 2017;207:357-61. PMID: 29020908.
• 6. Cooney MT, Dudina AL, Graham IM. Value and limitations of existing scores for the assessment of cardiovascular risk: a review for clinicians. Journal of the American College of Cardiology. 2009;54:1209-27. PMID: 19778661.
• 7. Angoorani P, Heshmat R, Ejtahed HS, Motlagh ME, Ziaodini H, Taheri M, et al. Validity of triglyceride-glucose index as an indicator for metabolic syndrome in children and adolescents: the CACSPIAN-V study. Eat Weight Disord. 2018;23:877-83. PMID: 29453589.
• 8. Da Silva A, Caldas APS, Hermsdorff HHM, Bersch-Ferreira ÂC, Torreglosa CR, Weber B, et al. Triglyceride-glucose index is associated with symptomatic coronary artery disease in patients in secondary care. Cardiovasc Diabetol. 2019;18:89. PMID: 31296225.
• 9. Selvarajah S, Kaur G, Haniff J, Cheong KC, Hiong TG, van der Graaf Y, et al. Comparison of the Framingham Risk Score, SCORE and WHO/ISH cardiovascular risk prediction models in an Asian population. Int J Cardiol 2014;176:211–8. PMID: 25070380.
• 10. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Atherosclerosis. 2016;252:207-74.
• 11. Paixao AR, Berry JD, Neeland IJ, Ayers CR, Rohatgi A, de Lemos JA, et al. Coronary artery calcification and family history of myocardial infarction in the Dallas heart study. JACC Cardiovasc Imaging. 2014;7:679-86. PMID: 24954461.
• 12. Virmani R, Kolodgie FD, Burke AP, Farb A, Schwartz SM. Lessons from sudden coronary death: A comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol 2000; 20:1262-75. PMID: 10807742.
• 13. Taylor AJ, Burke AP, O'Malley PG, Farb A, Malcom GT, Smialek J, et al. A comparison of the Framingham risk index, coronary artery calcification, and culprit plaque morphology in sudden cardiac death.Circulation. 2000;101:1243-8. PMID: 10725282.
• 14. Sandoval Y, Bielinski SJ, Daniels LB, Blaha MJ, Michos ED, DeFilippis AP, et al. Atherosclerotic Cardiovascular Disease Risk Stratification Based on Measurements of Troponin and Coronary Artery Calcium. J Am Coll Cardiol. 2020;76:357-70. PMID: 32703505.
• 15. Kopčeková J, Holovičová M, Gažarová M, Mrázová J, Habánová M, Mečiarová L, et al. Association between Selected Dietary Habits and Lipid Profiles of Patients with Cardiovascular Disease. Int J Environ Res Public Health. 2020;17:7605. PMID: 33086597
• 16. Kim MK, Ahn CW, Kang S, Nam JS, Kim KR, Park JS. Relationship between the triglyceride glucose index and coronary artery calcification in Korean adults. Cardiovasc Diabetol. 2017;16:108. PMID: 28830471.
• 17. Lee SB, Ahn CW, Lee BK, Kang S, Nam JS, You JH, et al. Association between triglyceride glucose index and arterial stiffness in Korean adults. Cardiovasc Diabetol. 2018;17:41. PMID: 29562908.
• 18. Zhao Q, Zhang TY, Cheng YJ, Ma Y, Xu YK, Yang JQ, et al. Impacts of triglyceride-glucose index on prognosis of patients with type 2 diabetes mellitus and non-ST-segment elevation acute coronary syndrome: results from an observational cohort study in China. Cardiovasc Diabetol. 2020;19:108. PMID: 32641127.
• 19. Nguyen HL, Liu J, Del CACstillo M, Shah T. Role of Coronary Calcium Score to Identify Candidates for ASCVD Prevention. Curr Atheroscler Rep. 2019;21:53. PMID: 31754800.
• 20. Martin SS, Blaha MJ, Blankstein R, Agatston A, Rivera JJ, Virani SS, et al. Dyslipidemia, coronary artery calcium, and incident atherosclerotic cardiovascular disease: implications for statin therapy from the multi-ethnic study of atherosclerosis. Circulation. 2014;129:77-86. PMID: 24141324.