Evaluation of the Association of the Total Cholesterol-to-High-Density Lipoprotein Cholesterol Ratio and Triglyceride-Glucose Index With Coronary Artery Disease and Their Diagnostic Utility

<b>Aims/Background</b> This study aimed to examine the relationship between coronary heart disease (CHD) severity, the triglyceride-glucose (TyG) index, and the total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) ratio while also assessing their diagnostic significance. A deeper understanding of the pathophysiology of CHD enables early detection, more precise screening of high-risk groups, and the development of more targeted treatment plans. <b>Methods</b> A total of 196 patients with suspected acute coronary syndrome (ACS) were included in this retrospective study, of whom 134 were diagnosed with CHD. Clinical, laboratory and coronary angiography (CAG) data were collected. CHD patients were classified into low-, medium-, and high-risk groups according to their Synergy Between Percutaneous Coronary Intervention (PCI) with Taxus and Cardiac Surgery (SYNTAX) scores. The correlations and clinical relevance of the TyG index and TC/HDL-C ratio were further examined by stratifying patients into single-, dual-, and multi-vessel groups according to the number of lesions. A <i>p</i>-value < 0.05 was considered statistically significant. <b>Results</b> Relative to non-CHD patients, CHD patients were significantly older and exhibited higher levels of TC, Triglycerides (TG), TyG index, and TC/HDL-C ratio (<i>p</i> < 0.05). Both the TyG index and TC/HDL-C ratio were independently associated with the risk of coronary atherosclerosis in univariate and multivariate logistic regression analyses (<i>p</i> < 0.05). The multi-vessel disease group had significantly higher TyG index and TC/HDL-C ratio values compared to the single- and dual-vessel groups (<i>p</i> < 0.05). Additionally, SYNTAX scores showed a significantly positive correlation with both indices (<i>p</i> < 0.05). The area under the curve (AUC) values for the TC/HDL-C ratio and TyG index were 0.918 and 0.893, respectively, both significantly greater than 0.5 (<i>p</i> < 0.05). <b>Conclusion</b> The TC/HDL-C ratio and TyG index are associated with the risk of CHD, with their values rising as coronary artery disease severity progresses. These indices may serve as valuable tools for predicting clinical severity in patients with coronary artery lesions.