Assessment of triglyceride glucose index as biochemical marker of severity in coronary artery disease

Objectives: Cardiovascular disease (CVD) is a major cause of morbidity and mortality across the world, posing serious public health challenges and also placing an economic burden on patients. According to the World Health Organization (WHO), cardiovascular diseases are one of the major causes of death in India and worldwide, resulting in a global burden. The present study is undertaken to estimate the triglyceride glucose (TyG) index in patients having coronary artery disease (CAD) with adverse outcomes and compare them to age-matched controls. Material and Methods: A total of 60 patients with coronary artery disease were included in the study, who were classified into group A and B based on their outcomes. Patients who are diagnosed with STEMI (ST-elevated myocardial infarction [MI]) and NSTEMI (non-ST-elevated myocardial infarction) with clinical features, electrocardiogram (ECG) abnormalities, or raised troponin I values. Major adverse cardiovascular and cerebrovascular events are identified as fatal MI, revascularization, stroke, and rehospitalization. The vacutainer is then centrifuged at 3000-5000 rpm for 15 minutes for the separation of serum. The serum is aliquoted into labeled Eppendorf tubes. They are analyzed immediately and stored in refrigeration at -40 °C until completion of the study process. The study was carried out in a 24-hour laboratory, the department of Biochemistry, and samples were obtained from the department of Cardiology, Government General Hospital, Rangaraya Medical College. Data collected - age, sex, blood glucose levels, serum triglyceride levels, and triglyceride glucose index. Results: The results of the study showed that the mean blood glucose levels and TyG index were increased in patients with adverse outcomes (Group A) compared with patients with stable outcomes (Group B) ( p = 0.014). In this study of 60 patients diagnosed with coronary artery disease, 51.66% ( n = 31) had adverse outcomes (Group A), whereas the remaining 48.33% ( n = 29) had stable outcomes (Group B). The mean value of the TyG index in Group A was 9.69, while in Group B it was 9.15. The p -value was 0.014, indicating that the difference was statistically significant at the 5% level. The TyG index is calculated from serum glucose and serum triglyceride (TG) levels using the formula ln [(FBS × TG)/2]. The TyG index is considered a reliable marker of insulin resistance, as it combines the diagnostic potential of fasting blood glucose and serum triglycerides. The TyG index was calculated based on the serum glucose and triglyceride levels using the aforementioned formula, and the values were recorded. On comparison, the TyG index was 9.69 ± 0.88 in Group A and 9.15 ± 0.76 in Group B. Conclusion: Our present study showed that increased serum triglyceride levels in patients with coronary artery disease may lead to adverse complications like increased blood glucose levels in patients with coronary artery disease leads to adverse outcomes. The TyG has been shown to have a tendency for increased values in case of adverse outcomes. Thus, the present study suggests that regular monitoring of the triglyceride glucose index in patients with coronary artery disease may help in the early detection of CAD.