A Novel Marker Triglyceride Glucose Index in Predicting the Development of No-reflow in Acute Coronary Syndrome without ST-segment Elevation

Aim: The triglyceride-glucose (TyG) index is a new marker that predicts adverse clinical outcomes in coronary artery disease. We aimed to investigate the relationship between the TyG index and the no-reflow phenomenon after percutaneous coronary intervention (PCI) to saphenous vein grafts (SVGs) in patients with non ST-elevation acute coronary syndrome (NSTE-ACS). Methods: In this retrospective study, 289 patients diagnosed with NSTE-ACS who underwent PCI for SVG obstruction were included. Patients were divided into 2 groups according to the development of a no-reflow phenomenon in the infarct-related artery after PCI: group 1 normal reflow group (n=209) and group 2 (n=80) no-reflow group. The groups were then compared according to the TyG index. Results: The TyG index (p<0.001) was significantly higher in the no-reflow group. Univariate and multivariate logistic regression identified that congestive heart failure (p<0.001), degenerated SVG (p=0.002), intraluminal thrombus (p<0.001), and TyG index (p<0.001) were independent no-reflow predictors. In the receiver operating characteristic curve analysis, the TyG index with an optimum threshold value of 0.82 detected the development of no-reflow with 70% sensitivity and 83.7% specificity. Conclusion: The TyG index, a simple measurable laboratory variable, is an independent predictor of no-reflow development in NSTEACS patients undergoing PCI for SVG occlusion.