Quantitative assessment of coronary plaque volume change related to triglyceride glucose index: The Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging (PARADIGM) registry

Ki-Bum Won, Byoung Kwon Lee, Hyung-Bok Park, Ran Heo, Sang-Eun Lee, Asim Rizvi, Fay Y Lin, Amit Kumar, Martin Hadamitzky, Yong-Jin Kim, Ji Min Sung, Edoardo Conte, Daniele Andreini, Gianluca Pontone, Matthew J Budoff, Ilan Gottlieb, Eun Ju Chun, Filippo Cademartiri, Erica Maffei, Hugo Marques, Pedro de Araújo Gonçalves, Jonathon A Leipsic, Sanghoon Shin, Jung Hyun Choi, Renu Virmani, Habib Samady, Kavitha Chinnaiyan, Gilbert L Raff, Peter H Stone, Daniel S Berman, Jagat Narula, Leslee J Shaw, Jeroen J Bax, James K Min, Hyuk-Jae Chang, Ki-Bum Won, Byoung Kwon Lee, Hyung-Bok Park, Ran Heo, Sang-Eun Lee, Asim Rizvi, Fay Y Lin, Amit Kumar, Martin Hadamitzky, Yong-Jin Kim, Ji Min Sung, Edoardo Conte, Daniele Andreini, Gianluca Pontone, Matthew J Budoff, Ilan Gottlieb, Eun Ju Chun, Filippo Cademartiri, Erica Maffei, Hugo Marques, Pedro de Araújo Gonçalves, Jonathon A Leipsic, Sanghoon Shin, Jung Hyun Choi, Renu Virmani, Habib Samady, Kavitha Chinnaiyan, Gilbert L Raff, Peter H Stone, Daniel S Berman, Jagat Narula, Leslee J Shaw, Jeroen J Bax, James K Min, Hyuk-Jae Chang

Abstract

Background: The association between triglyceride glucose (TyG) index and coronary atherosclerotic change remains unclear. We aimed to evaluate the association between TyG index and coronary plaque progression (PP) using serial coronary computed tomography angiography (CCTA).

Methods: A total of 1143 subjects (aged 60.7 ± 9.3 years, 54.6% male) who underwent serial CCTA with available data on TyG index and diabetic status were analyzed from The Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging (PARADIGM) registry. PP was defined as plaque volume (PV) (mm3) at follow-up minus PV at index > 0. Annual change of PV (mm3/year) was defined as PV change divided by inter-scan period. Rapid PP was defined as the progression of percent atheroma volume (PV divided by vessel volume multiplied by 100) ≥ 1.0%/year.

Results: The median inter-scan period was 3.2 (range 2.6-4.4) years. All participants were stratified into three groups based on TyG index tertiles. The overall incidence of PP was 77.3%. Baseline total PV (group I [lowest]: 30.8 (0.0-117.7), group II: 47.2 (6.2-160.4), and group III [highest]: 57.5 (8.4-154.3); P < 0.001) and the annual change of total PV (group I: 5.7 (0.0-20.2), group II: 7.6 (0.5-23.5), and group III: 9.4 (1.4-27.7); P = 0.010) were different among all groups. The risk of PP (odds ratio [OR] 1.648; 95% confidence interval [CI] 1.167-2.327; P = 0.005) and rapid PP (OR 1.777; 95% CI 1.288-2.451; P < 0.001) was increased in group III compared to that in group I. TyG index had a positive and significant association with an increased risk of PP and rapid PP after adjusting for confounding factors.

Conclusion: TyG index is an independent predictive marker for the progression of coronary atherosclerosis. Clinical registration ClinicalTrials.gov NCT02803411.

Keywords: Atherosclerosis; Coronary artery disease; Coronary computed tomography angiography; Triglyceride glucose index.

Conflict of interest statement

Dr. James K. Min receives funding from the Dalio Foundation, National Institutes of Health, and GE Healthcare. Dr. Min serves on the scientific advisory board of Arineta and GE Healthcare, and has a clear equity interest. Dr. Habib Samaday has equity interest in Covanos. All other authors declared no conflict of interest.

Figures

Fig. 1
Fig. 1
Representative CCTA images. CCTA coronary computed tomography angiography, TyG triglyceride glucose
Fig. 2
Fig. 2
Subgroup analysis for the impact of TyG index on coronary PP. TyG triglyceride glucose, PP plaque progression

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