The triglyceride-glucose index and neutrophil-to-lymphocyte ratio jointly predict the no-reflow phenomenon in T2DM patients with STEMI after primary PCI.

The incidence of no-reflow phenomenon in T2DM patients with STEMI after primary PCI was 8.97%.

• 47 out of 524 patients experienced no-reflow
• No-reflow was defined as post-procedural TIMI flow grade ≤2
• The study population was a retrospective cohort of 524 patients with T2DM and STEMI undergoing PPCI

The TyG index was identified as an independent predictor of no-reflow after multivariable logistic regression.

• Adjusted odds ratio (aOR) for TyG index was 2.98
• The optimal cut-off for TyG index was 9.347
• Multivariable logistic regression analysis was used to identify independent predictors

The NLR was identified as an independent predictor of no-reflow after multivariable logistic regression.

• Adjusted odds ratio (aOR) for NLR was 1.23
• The optimal cut-off for NLR was 2.831
• NLR was assessed alongside TyG index in multivariable logistic regression

Patients with both high TyG index and high NLR had a substantially higher no-reflow incidence compared to the low-risk group.

• Patients were stratified into four groups based on optimal cut-offs for NLR (2.831) and TyG (9.347)
• The high-high group had a no-reflow incidence of 23.21%
• The low-risk group (low levels of both markers) had a no-reflow incidence of only 1.49%

The combined TyG + NLR model demonstrated superior predictive performance over models containing either marker alone or baseline clinical factors.

• The combined model achieved an AUC of 0.785
• ROC curve analyses were employed to assess predictive performance
• The combined model outperformed models using either TyG index alone, NLR alone, or baseline clinical factors alone