The Relationship between TyG, AIP, NHR and PIV and Coronary Lesion Burden in Patients with Early-Onset Coronary Heart Disease: A Single-Centre Retrospective Cross-Sectional Study

Abstract Background To compare the associations between the triglyceride-glucose index (TyG), atherogenic index of plasma (AIP), neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) and pan-immune-inflammation value (PIV) with the coronary artery disease burden in patients with early-onset coronary heart disease. Methods A retrospective study was conducted involving 781 patients with early-onset coronary heart disease at Qingdao Municipal Hospital between January 2021 and July 2025. Spearman’s correlation, the quartile trend test and multivariate linear regression were employed, with the regression outcome defined as ln(Gensini score + 1). All four indicators were standardised; specifically, the natural logarithms of the NHR and PIV were calculated in advance. Regression analysis utilised HC3 robust standard errors, and restricted cubic spline, mutual adjustment, sensitivity and subgroup analyses were conducted. Results All four indicators were positively correlated with the Gensini score, which generally increased as the quartiles of the indicators rose. After adjusting for clinical covariates, NHR (β = 0.137, 95% CI: 0.066–0.208) and PIV (β = 0.154, 95% CI: 0.086–0.222) showed positive associations in their respective models (both P < 0.001), whilst the associations for TyG and AIP were not statistically significant. When NHR and PIV were modelled together, the association with PIV was statistically significant (β = 0.117, 95% CI: 0.033–0.201, P = 0.0065), whilst the association with NHR was not significant. After excluding the top 1% of PIV observations, the effect estimates were similar to those in the primary analysis. Neither the tests for non-linearity nor for subgroup interactions reached statistical significance. Conclusion Inflammation-related composite indices are associated with the coronary artery disease burden in patients with early-onset coronary heart disease; PIV shows a consistent positive association across different adjustment frameworks.