{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T01:47:19Z","timestamp":1782265639029,"version":"3.54.5"},"reference-count":39,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The triglyceride\u2013glucose (TyG) index has emerged as a simple surrogate marker of insulin resistance and metabolic disruption. In the context of ST-elevation myocardial infarction (STEMI), such disturbances have been associated with adverse cardiovascular outcomes, more complex angiographic profiles, and microvascular complications. However, data on the association between TyG and intracoronary thrombus burden (TB) in STEMI remain limited. Methods: In this prospective observational study, we included consecutive STEMI patients treated with primary percutaneous coronary intervention (pPCI). The TyG index was calculated using the following formula: ln [fasting triglycerides (mg\/dL) \u00d7 fasting glucose (mg\/dL)\/2]. TB was graded according to the modified thrombolysis in myocardial infarction (mTIMI) thrombus classification score after restoration of antegrade flow with a wire or small balloon when the culprit vessel was initially totally occluded. Patients were categorized as low-TB (LTB; mTIMI grades 1\u20133) and high-TB (HTB; mTIMI grade 4). The primary outcome was HTB; secondary outcomes were distal embolization and no-reflow. Associations between TyG and outcomes were assessed using univariable and multivariable logistic regression, restricted cubic spline analysis, and receiver operating characteristic (ROC) curves to evaluate incremental predictive value. Results: A total of 309 patients were analyzed. The TyG index was significantly higher in the HTB group compared with the LTB group (9.12 \u00b1 0.62 vs. 8.92 \u00b1 0.64, p = 0.004). In a stepwise multivariable model, TyG remained independently associated with HTB (adjusted odds ratio = 1.61; 95% confidence interval: 1.11\u20132.37; p = 0.014). Adding TyG to a baseline clinical model only numerically improved discrimination for HTB, as reflected by a small increase in ROC area under the curve. Restricted cubic spline analysis demonstrated a monotonic rise in the probability of HTB with higher TyG values. Higher TyG also showed non-significant trends toward increased odds of distal embolization and no-reflow. Conclusions: The TyG index was independently associated with HTB in STEMI patients undergoing pPCI and may serve as an accessible adjunctive marker for incremental risk stratification beyond conventional clinical and angiographic factors.<\/jats:p>","DOI":"10.3390\/jcm15124793","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T01:03:23Z","timestamp":1782263003000},"page":"4793","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Triglyceride\u2013Glucose Index with Angiographic Thrombus Burden in Patients with ST-Elevation Myocardial Infarction: A Prospective Observational Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0190-5392","authenticated-orcid":false,"given":"Nikolaos","family":"Stalikas","sequence":"first","affiliation":[{"name":"Cardiovascular Center Aalst, AZORG Ziekenhuis, Moorselbaan 164, 9300 Aalst, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9409-388X","authenticated-orcid":false,"given":"Marios G.","family":"Bantidos","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, AHEPA General University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"},{"name":"Second Department of Cardiology, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8328-5942","authenticated-orcid":false,"given":"Efstratios","family":"Karagiannidis","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, AHEPA General University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3057-5297","authenticated-orcid":false,"given":"Athina","family":"Nasoufidou","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Corradetti","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, AZORG Ziekenhuis, Moorselbaan 164, 9300 Aalst, Belgium"},{"name":"Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1551-4624","authenticated-orcid":false,"given":"Anthony","family":"Kechichian","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, AZORG Ziekenhuis, Moorselbaan 164, 9300 Aalst, Belgium"},{"name":"Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Kofos","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Fasoula","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, AHEPA General University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8046-0602","authenticated-orcid":false,"given":"Matthaios","family":"Didagelos","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, AHEPA General University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3473-1368","authenticated-orcid":false,"given":"Marios","family":"Sagris","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tzaneio General Hospital of Piraeus, 18536 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0019-0134","authenticated-orcid":false,"given":"Barbara","family":"Fyntanidou","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, AHEPA General University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonios","family":"Ziakas","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, AHEPA General University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4658-5273","authenticated-orcid":false,"given":"Theodoros","family":"Karamitsos","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, AHEPA General University Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7287-3850","authenticated-orcid":false,"given":"Georgios","family":"Giannopoulos","sequence":"additional","affiliation":[{"name":"Third Department of Cardiology, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1089\/met.2008.0034","article-title":"The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects","volume":"6","year":"2008","journal-title":"Metab. 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