Association of triglyceride glucose index levels ​​with calcification patterns and vulnerability of plaques: an intravascular ultrasound study

Purpose: High triglyceride glucose (TyG) index level is one of the risks for cardiovascular events. The purpose of this research was to examine the correlation of the triglyceride glucose (TyG) index levels with plaque characteristics and calcification types determined by intravascular ultrasound (IVUS) in acute coronary syndrome (ACS) patients. Methods: A total of 234 acute coronary syndromes (ACS) participants who completed intravascular ultrasound (IVUS) and coronary angiography (CAG) were finally enrolled. Results: Logistic regression analysis manifested that the TyG index was independently correlated with the occurrence of coronary calcification, minimum lumen area (MLA) ≤ 4.0 mm², plaque burden (PB) > 70%, and spotty calcification. Taking the lowest group as a reference, the risk of coronary calcification (OR, 2.57; 95%CI, 1.04–6.35; p = 0.040), MLA ≤ 4.0 mm² (OR, 7.32; 95%CI, 2.67–20.01; p < 0.001), PB > 70% (OR, 2.68; 95%CI, 1.04–6.91; p = 0.041), and spotty calcification (OR, 1.48; 95%CI, 0.59–3.71; p = 0.407) was higher in the highest TyG index group. TyG index was converted into a dichotomous variable or a continuous variable for analysis, and we found that a similar result was observed. In addition, optimal predictive models consisting of clinical variables and the TyG index distinctly improved the ability to predict the prevalence of coronary calcification and MLA ≤ 4.0 mm² (p < 0.05). Conclusion: The TyG index may serve as a potential predictor for calcification patterns and plaque vulnerability.