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Assessment of the relationship between J-CTO score and Triglyceride-Glucose index in patients with chronic total

Ecem Gürses1, Zeynep Yapan Emren1, Fatih Sivri1

  • 1Department of Cardiology, Bakırçay University Çiğli Training and Research Hospital, İzmir, Turkey.

Acta Cardiologica
|February 10, 2026
PubMed

Insights

The triglyceride-glucose (TyG) index is a significant predictor of higher J-CTO scores in patients with chronic total occlusion (CTO) and coronary artery disease (CAD). A high TyG index independently indicates increased revascularization difficulty.

Area of Science:

  • Cardiology
  • Metabolic Syndrome
  • Vascular Biology

Background:

  • Chronic total occlusion (CTO) poses challenges in coronary artery disease (CAD) management.
  • The J-CTO score estimates revascularization difficulty, while the triglyceride-glucose (TyG) index reflects insulin resistance and atherosclerosis risk.

Purpose of the Study:

  • To investigate the association between the J-CTO score and the TyG index in patients with CTO.
  • To determine if the TyG index can predict revascularization difficulty in CTO patients.

Main Methods:

  • Retrospective single-centre study of 243 patients with CTO undergoing percutaneous coronary intervention (PCI).
  • Coronary angiography and blood tests for TyG index assessment were performed.
  • Patients were stratified by J-CTO score into low (0-1) and high (2-3) difficulty groups.

Main Results:

  • The high J-CTO score group (n=141) exhibited significantly higher age, uric acid, hs-CRP, LDL-C, and TyG index compared to the low J-CTO score group (n=102).
  • Multivariate analysis identified TyG index, age, LDL-C, hs-CRP, and uric acid as independent risk factors for high J-CTO scores.

Conclusions:

  • This study is the first to establish the TyG index as an independent risk factor for elevated J-CTO scores.
  • The TyG index may serve as a valuable biomarker for predicting revascularization complexity and long-term prognosis in CTO patients.
Abstract

Keywords:
J-CTO scoreTriglyceride glucose indexchronic total occlusion

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