Triglycerides glucose index and high-sensitivity C-reactive protein are predictors of outcome in chronic coronary syndrome

Funding Acknowledgements Type of funding sources: None. Background It is unknown whether insulin resistance (IR) and inflammation identify residual prognostic risk in patients with chronic coronary syndrome (CCS). Aims To assess whether the triglyceride-glucose (TyG) index and high-sensitivity C-reactive protein (hs-CRP) are independent predictors of outcome in CCS. Methods TyG index and hs-CRP were evaluated in 1097 consecutive patients (75% men, median age 72 years) with known (26%) or suspected coronary artery disease (CAD) undergoing stress-rest myocardial perfusion scintigraphy (MPS) and coronary angiography and followed-up for a median of 4.5-year. Results Moderate/severe perfusion abnormalities during stress were documented in 60% of patients, obstructive CAD in 74%, and 36% underwent early revascularization. TyG index was 8.9 (median, interquartile interval 8.6-9.2) and of hs-CRP was 0.3 mg/L (0.1-0.8). Cardiac death or myocardial infarction occurred in 103 patients and all-cause death in 65. Patients in the fourth TyG quartile (TyG ≥ 9.2), with hs-CRP ≥ 2 mg/L or with both had the shortest survival free from cardiac events or all-cause death. TyG predicted cardiac events (HR 2.46, 95% CI 1.59-3.79, p Conclusions The TyG index identifies a high residual risk of cardiac events in patients with CCS. The TyG index and hs-CRP are strong and interacting predictors of all-cause death.