Association of the TyG index and inflammatory burden index with AMR-defined coronary microvascular dysfunction and 12-month MACE after STEMI.

Authors

Yang Yang, Leilei Liu, Xiuyu Liang, Xiaohong Zhang, Hai Xu

Published in

Frontiers in endocrinology. Volume 17. Pages 1900132. Epub Aug 07, 2026.

Abstract

Metabolic dysfunction and inflammation may jointly contribute to coronary microvascular injury and adverse outcomes after primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI). We examined the independent and combined associations of the triglyceride-glucose (TyG) index and inflammatory burden index (IBI) with angiographic microvascular resistance (AMR)-defined coronary microvascular dysfunction (CMD), their incremental value beyond conventional factors, and their associations with 12-month major adverse cardiovascular events (MACE).
In this retrospective cohort study conducted at a single center, 318 STEMI patients who underwent PPCI and achieved a TIMI grade 3 flow post-procedure were enrolled. AMR was derived from the final post-PPCI angiogram of the culprit vessel, and CMD was defined as AMR >26.6 mmHg·s/dm. Multivariable models assessed associations with CMD and MACE. Sequential models evaluated the incremental performance of TyG and IBI with 1,000-resample bootstrap internal validation.
CMD was present in 102/318 (32.1%). TyG (OR per 1-unit, 3.83; 95% CI, 2.04-7.21; P<0.001) and IBI (OR per 10-units, 1.13; 95% CI, 1.07-1.20; P<0.001) were independently associated with CMD. The TyG-IBI model showed an AUC of 0.773 for CMD; adding both to a clinical/procedural model improved the AUC from 0.904 to 0.939 (bootstrap-validated, 0.920; ΔAUC, 0.036; P = 0.001). Over 12 months, 69 (21.7%) patients had MACE. TyG (HR, 1.97; 95% CI, 1.30-2.98; P = 0.001) and IBI (HR per 10-units, 1.02; 95% CI, 1.00-1.05; P = 0.022) remained independent predictors of MACE, with the highest risk in those with both markers elevated.
TyG and IBI were independently associated with AMR-defined CMD and 12-month MACE after STEMI. Adding TyG and IBI to conventional clinical and procedural factors improved model discrimination for CMD, although prospective multicenter validation is required before clinical application.

PMID:
42630147
Bibliographic data and abstract were imported from PubMed on 22 Aug 2026.

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