Study on the association between triglyceride-glucose index and clinical characteristics of myocardial infarction in 5,001 patients with coronary artery disease

Background: The triglyceride-glucose (TyG) index, a reliable surrogate for insulin resistance, reflects cardiometabolic status and correlates with coronary artery disease (CAD) progression. Myocardial infarction (MI)—CAD’s most severe acute manifestation with high morbidity and mortality—is critical for CAD risk stratification. While the TyG index is linked to CAD in specific subgroups, its association with MI clinical characteristics in unselected CAD cohorts remains unclear. This study investigates this relationship in a large cohort, adjusts for confounders, and verifies consistency via subgroup analyses, providing etiological clues for their potential link and informing CAD management. Methods: A total of 5,001 patients that had been diagnosed with CAD between September 2018 and September 2021 at Jiangnan University Medical Center and Jiangsu Provincial Hospital were recruited into this study. Medical record data, treatment regimens, and clinical outcomes of these patients were collected for a cross-sectional study analysis. Patients were stratified into four groups based on the quartile levels of their TyG index: Q1 (n=1,254, TyG index ≤8.31), Q2 (n=1,243, 8.31< TyG index ≤8.69), Q3 (n=1,256, 8.69< TyG index ≤9.15), and Q4 (n=1,248, TyG index >9.15). Multivariate logistic regression analysis was performed to explore the association between the TyG index and clinical characteristics of MI in patients with CAD. Results: In a multivariate logistic regression analysis of 5,001 patients with CAD, the results showed that with the increase in TyG index, the strength of the association between the TyG index and diagnosis of MI in CAD patients gradually increased compared with patients with angina pectoris [Q2: odds ratio (OR) =1.31, 95% confidence interval (CI): 1.07–1.60; Q3: OR =1.39, 95% CI: 1.13–1.71; Q4: OR =1.72, 95% CI: 1.38–2.15; P