TyG index and inflammatory burden index were independently associated with AMR-defined coronary microvascular dysfunction and 12-month MACE after STEMI, and adding both markers to conventional clinical and procedural factors improved model discrimination for CMD.
Coronary microvascular dysfunction (CMD), defined as AMR >26.6 mmHg·s/dm, was present in approximately one-third of STEMI patients after successful PPCI.
The TyG index was independently associated with AMR-defined CMD in STEMI patients after PPCI.
The inflammatory burden index (IBI) was independently associated with AMR-defined CMD in STEMI patients after PPCI.
A model combining TyG and IBI alone achieved an AUC of 0.773 for predicting CMD.
Adding TyG and IBI to a conventional clinical and procedural model significantly improved discrimination for CMD.
Over 12 months of follow-up, 21.7% of STEMI patients experienced major adverse cardiovascular events (MACE).
TyG index was an independent predictor of 12-month MACE after STEMI.
IBI was an independent predictor of 12-month MACE after STEMI, though with a modest effect size per 10-unit increment.
Patients with both TyG and IBI elevated had the highest risk for 12-month MACE.
This research suggests that two blood-based markers — the triglyceride-glucose (TyG) index, which reflects metabolic dysfunction, and the inflammatory burden index (IBI), which captures systemic inflammation — are each independently linked to a condition called coronary microvascular dysfunction (CMD) in patients who suffered a serious type of heart attack (STEMI) and underwent emergency stenting (PPCI). CMD means that the tiny blood vessels of the heart are not working properly even after the blocked artery has been reopened, and it occurred in about one in three patients in this study. Higher levels of both the TyG index and the IBI were associated with greater odds of having CMD after the procedure. The study also found that patients with higher TyG and IBI levels were more likely to experience serious cardiovascular complications — such as heart attack, death, or other events — within 12 months of the procedure. Patients who had both markers elevated at the same time faced the highest risk. When TyG and IBI were added to standard clinical information used to predict CMD, the ability of the prediction model to correctly classify patients improved meaningfully, with the area under the curve rising from 0.904 to 0.939. This research suggests that routinely measuring these two markers in heart attack patients could help identify those at higher risk for persistent microvascular problems and future cardiovascular events. However, the authors caution that this was a single-center retrospective study, and prospective multicenter validation is needed before these findings can be applied in routine clinical practice.
Yang Y, Liu L, Liang X, Zhang X, Xu H. (2026). Association of the TyG index and inflammatory burden index with AMR-defined coronary microvascular dysfunction and 12-month MACE after STEMI.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1900132