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Comparison of TyG and modified TyG indices in predicting coronary slow flow phenomenon.

Jing Nan1, Shuai Meng1, Ruofei Jia1

  • 1Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

BMC Cardiovascular Disorders
|April 29, 2025
PubMed
Summary

The triglyceride-glucose (TyG) index and its modified versions, TyG-WC and TyG-BMI, are independent risk factors for coronary slow flow phenomenon (CSFP). TyG-WC demonstrated the best predictive performance for CSFP among the evaluated indices.

Keywords:
Coronary slow flow phenomenalIschemia with no obstructive coronary arteryTriglyceride glucose ratioTriglyceride glucose ratio- waist circumference

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Area of Science:

  • Cardiology
  • Metabolic Syndrome Research
  • Vascular Physiology

Background:

  • Coronary slow flow phenomenon (CSFP) is a common condition in patients with ischemia and non-obstructive coronary artery disease (INOCA).
  • The triglyceride-glucose (TyG) index and its modified indices are associated with CSFP.
  • A comparative analysis of the predictive value of TyG and its modified indices for CSFP was lacking.

Purpose of the Study:

  • To compare the clinical value of the triglyceride-glucose (TyG) index and its modified indices in predicting coronary slow flow phenomenon (CSFP).
  • To identify independent risk factors for CSFP in patients with ischemia and non-obstructive coronary artery disease (INOCA).

Main Methods:

  • Retrospective enrollment of 4,627 INOCA patients, divided into CSFP (69 patients) and non-CSFP (586 patients) groups based on corrected TIMI counts.
  • Comparison of demographic, clinical risk factors, and laboratory results, including TyG and modified indices (TyG-WC, TyG-BMI).
  • Prognostic value assessed using receiver operating characteristic (ROC) curves and area under the curve (AUC) analysis.

Main Results:

  • Patients with CSFP exhibited higher BMI, uric acid, triglyceride, total cholesterol, LDL-C, and homocysteine levels.
  • Both TyG and its modified indices (TyG-WC, TyG-BMI) were independently associated with CSFP.
  • TyG-WC demonstrated superior predictive performance for CSFP compared to other indices, with consistent value across subgroups, particularly in males.

Conclusions:

  • The triglyceride-glucose (TyG) index, TyG-WC, and TyG-BMI are confirmed as independent risk factors for coronary slow flow phenomenon (CSFP).
  • TyG-WC exhibits the highest predictive accuracy for CSFP among the evaluated indices.
  • These findings highlight the potential of TyG-WC as a valuable non-invasive biomarker for CSFP risk stratification.