The Predictive Value Of TyG Index Combined With PTP Score For The Degree Of Coronary Artery Disease In Patients With Suspected Chronic Coronary Syndrome

Objective: To explore the predictive value of triglyceride glucose index(TyG index)combined with pretest probability(PTP)score for the risk stratification of cor-onary artery disease in suspected patients with chronic coronary syndrome.Method: Collect clinical data of suspected chronic coronary syndrome patients ad-mitted to the cardiology department of Dalian Central Hospital from September 2020 to September 2022,and calculate admission TyG index,PTP score,Gensini score,etc.According to the results of coronary angiography(CAG),the subjects were divided into coronary heart disease group(n=365)and non coronary heart disease group(n=215).The difference in the constituent ratio of categorical variable was compared with chi square test,and the difference between continuous variables was compared with independent sample t test.Using binary logistic regression analysis to screen inde-pendent risk factors for coronary stenosis in patients with chronic coronary syndrome;The receiver operator characteristic curve(ROC)curve was used to evaluate the predi-ctive efficacy of independent predictive indicators and their combined diagnosis for chronic coronary syndrome.The predictive efficacy was compared with the Gensini score.Correlation analysis was used to test the correlation between the TyG index combined with PTP score and Gensini score.Linear regression analysis was used to explore the predictive role of the TyG index and PTP score on Gensini score.Result:1.Baseline data:This study included a total of 580 suspected patients with chronic coronary syndr-ome,including the coronary heart disease group(n=365)and the non coronary heart disease group(n=215).Among the coronary heart disease group,there were 230 male-s(69.7%)more than 135 females(54.0%),and 100 males(30.3%)were less than 115 females(46.0%)in the non coronary heart disease group.The fasting blood glucose(6.33 ± 2.06 mmol/L)of the coronary heart disease group was higher than that of the non coronary heart disease group(5.87 ± 1.46 mmol/L),The TyG index in the coronary heart disease group(8.93 ± 0.58)was higher than that in the non coronary heart disease group(8.71 ± 0.57),the PTP score in the coronary heart disease group(31.76 ± 13.56)was higher than that in the non coronary heart disease group(17.92 ± 8.82),and the smoking history,diabetes history,drinking history,cerebrovascular disease history,age,hypoglycemic drug use,left atrial diameter(LAD)Left ventricul-ar diameter(LVD),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),fasting blood glucose,triglyceride glucose index(TyG index),PTP score,left ventricular ejection fraction,creatinine,and fibrinogen(FIB)were significantly different between the two groups(P<0.05),while other indicators were not significantly different.2.Regression analysis:History of cerebrovascular disease,FIB,TyG index,and PTP score have a positive predictive effect on the occurrence of chronic coronary syndrome.Patients with a history of cerebrovascular disease have a 2.866 times higher risk of developing coronary heart disease compared to those without a history of cerebrovascular disease;The higher the TyG index,the greater the risk of developing chronic coronary syndrome;The higher the PTP score,the greater the risk of developing chronic coronary syndrome;The higher the FIB,the greater the risk of developing chronic coronary syndrome;The higher the TyG index,the greater the risk of developing chronic coronary syndrome.3.Comparison of predictive performance:The combination of TyG index and PTP score has a good predictive effect on the clinical likelihood of chronic coronary syndrome,with a specificity of 82.6%,which is superior to the predictive effect of using PTP score alone(specificity of 86.9%)or TyG index(specificity of 43.7%)on chronic coronary syndrome;The predictive power of the combined diagnosis of cerebrovascular disease history,FIB,TyG index,and PTP score(sensitivity of 71.2%,specificity of 82.6%)is better than that of individual diagnosis.The predictive power of cerebrovascular disease history(specificity of 97.2%,sensitivity of 8.2%);FIB(sensitivity 63.7%,specificity only 47.4%);PTP score(sensitivity 65.9%,specificity 86.9%)or TyG index(sensitivity75.3%,specificity 43.7%)TyG index ≥ 8.56 and PTP score>26.5 are independent risk factors for chronic coronary syndrome.Conclusion:1.The predictive power of the TyG index combined with PTP score in predicting the degree of coronary artery disease in chronic coronary syndrome is superior to the predictive power of both individual diagnoses.2.History of cerebrovascular disease,FIB,TyG index,and PTP score have a positive predictive effect on the occurrence of CCS.3.TyG index and PTP score are positively correlated with Gensini score.The higher the value,the more serious the coronary artery stenosis.4.TyG index ≥ 8.56 and PTP score>26.5 are independent risk factors for the occurrence of chronic coronary syndrome...