Introduction: Coronary artery ectasia (CAE) refers to a 1.5 fold increase in coronary artery diameter compared to the normal segment. Although the underlying pathophysiological mechanism is not fully elucidated, coronary atherosclerosis is thought to play a role in more than half of the cases. Triglyceride glucose (TyG) index is an indicator of insulin resistance. In the present study, aimed to evaluated TyG index values in CAE cases and find if a predictive value of TyG index existed. Patients and Methods: Sixty-one patients with CAE (study group) and 64 patients with normal coronary arteries (control group) were included in the study. TyG index was calculated as ln (fasting triglyceride × fasting glucose/2). Results: There were no differences between the two groups with respect to age, sex, diabetes mellitus prevalence, and biochemical parameters including, white blood cell, platelet, lymphocyte, monocyte counts, hemoglobin, hematocrit, urea, glucose, total cholesterol, high density lipoprotein-cholesterol, triglyceride levels and TyG index value. Twenty-five patients (41.0%) had one-vessel involvement, 24 (39.3%) patients had twovessel involvement and 12 (19.7%) patients had three-vessel involvement. Right coronary artery was the most commonly affected vessel (11, 44%), followed by left anterior descending artery (8, 35%), left main coronary artery (4, 16%) and circumflex artery (1, 4%). TyG index was statistically significantly higher in patients who had two/three vessel involvement (8.80 ± 0.48 vs 9.14 ± 0.62, p= 0.027). TyG index had statistically significant correlation with the number of ectatic vessels (r= 0.275, p= 0.032). ROC curve analysis showed that TyG index was useful for the prediction of ectasia severity (AUC= 0.653, 95% CI= 0.515-0.792, p= 0.043). TyG index value of 9.16 had 41.7% sensitivity and 84% specificity for prediction of CAE severity. Conclusion: TyG index, which is easily calculated from biochemical parameters, might be used for the assessment of CAE severity.

Background: Atherosclerotic cardiovascular disease remains the leading cause of ischemic heart disease, with dyslipidemia representing one of its principal modifiable risk factors. This study sought to evaluate the association between residual coronary artery disease burden and contemporary lipid indices in patients presenting with a first episode of acute coronary syndrome. Methods: A total of 317 patients were retrospectively evaluated between January 2022 and June 2023. Demographic features, comorbid conditions, laboratory measurements, conventional lipid parameters, contemporary lipid ratios, SYNTAX scores (SS), and residual SYNTAX scores (rSS) were recorded. Following primary percutaneous coronary intervention (PCI), patients were categorized by residual SYNTAX score (rSS) as rSS-negative (score = 0) or rSS-positive (score ≥ 1). Results: Of the 317 patients, 174 had an rSS > 0, with a median rSS of 6 (IQR, 3–10). Patients with rSS > 0 had lower HDL-C and higher LDL-C/HDL-C and non-HDL-C/HDL-C ratios than those with rSS = 0. In adjusted models, HDL-C was inversely associated with rSS positivity (OR per 1-mg/dL increase, 0.965; 95% CI, 0.932–0.999), whereas the LDL-C/HDL-C ratio (OR per 1-unit increase, 1.337; 95% CI, 1.021–1.752) and the non-HDL-C/HDL-C ratio (OR per 1-unit increase, 1.257; 95% CI, 1.017–1.553) were positively associated. Baseline SYNTAX score was the dominant predictor, and none of the lipid-extended models significantly improved discrimination over the reference model. Conclusions: HDL-C, the LDL-C/HDL-C ratio, and the non-HDL-C/HDL-C ratio were independently associated with residual SYNTAX score positivity following primary PCI in patients presenting with a first ACS. These routinely available lipid indices may provide complementary information regarding the presence of residual coronary disease in this specific patient population.