# Acute Coronary Syndrome in Intensive Care Unit Patients: Troponin or Triglyceride Glucose Index Levels?

## TL;DR

This study shows that the Triglyceride-Glucose Index (TyG) is a strong predictor of acute coronary syndrome in ICU patients, outperforming troponin levels.

## Contribution

The study demonstrates that TyG is a novel and significant predictor of acute coronary syndrome independent of hospitalization reasons.

## Key findings

- The TyG index was significantly higher in patients with acute coronary syndrome compared to those without.
- TyG was identified as the most significant predictor of ACS, with a 30.994-fold increase in probability.
- Triglyceride and glucose levels were also higher in the ACS group, but TyG was the strongest indicator.

## Abstract

Background and Objectives: There are few studies suggesting that the Triglyceride–Glucose Index (TyG), which is mostly defined as a predictor of diabetes, can be used as a predictor of coronary artery disease. In this study, we investigated the relationship between TyG index and acute coronary syndrome (ACS). Materials and Methods: Patients who were hospitalized in the coronary intensive care unit between January 2023–December 2024 were included in the study regardless of the admission diagnosis. ACS defined as ST elevation myocardial infarction (STEMI) and non-STEMI. The TyG index was calculated with the formula LN [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. The relationship between the presence of acute coronary syndrome and troponin level was compared with the TyG index. Results: A total of 586 individuals, 353 (60.2%) males and 233 (39.8%) females, were included in this study. The mean TyG index value was calculated as 75 ± 0.31 (4.03–5.99). ACS was detected in 36.9% (n = 216) of the participants. The mean TyG index was higher in the group with ACS (4.92 ± 0.29) than in the group without ACS (4.65 ± 0.27), p < 0.001). Similarly, the mean value of triglyceride (171.58 ± 114.45 vs. 120.92 ± 63.02, CI 95%, p < 0.001) and glucose (133.57 ± 48.87 vs. 104.88 ± 34.76, CI 95%, p < 0.001) were also higher in the group with acute coronary syndrome. In logistic regression analysis, the TyG index was identified as the most significant predictor of ACS, associated with a 30.994-fold increase in ACS probability. Conclusions: This study demonstrated that the TyG index is a significant predictor of acute coronary syndrome independent of the hospitalization reason. The TyG index can be used as a valuable marker in clinical practice because it includes modifiable risk factors for coronary artery disease.