Ecem Gürses, Zeynep Yapan Emren, Fatih Sivri
OBJECTIVE: In patients with chronic total occlusion (CTO) and coronary artery disease (CAD), the J-CTO score reflects the difficulty of revascularization, while the triglyceride-glucose (TyG) index is an indicator of insulin resistance and atherosclerosis. The aim of this study is to explore the relationship between the J-CTO score and the TyG index in patients with chronic total occlusion. METHODS: This is a single-centre, retrospective study conducted with approval from the local ethics committee. A total of 243 patients who underwent coronary angiography and percutaneous coronary intervention (PCI) due to stable CAD between 1 October 2022, and 1 October 2024, and were found to have chronic total occlusion, were included. The relationship between the J-CTO score and the TyG index, evaluated through blood tests, was assessed. RESULTS: Of the 243 patients, 102 were classified into the low difficulty group (J-CTO score 0-1), and 141 were in the high difficulty group (J-CTO score 2-3). The high difficulty group had significantly higher levels of age, uric acid, hs-CRP, LDL-C, and TyG index compared to the low difficulty group. Univariate and multivariate regression analyses identified age, LDL-C, hs-CRP, uric acid, and the TyG index as independent risk factors in the high difficulty group. CONCLUSION: This study is the first to demonstrate that a high TyG index is an independent risk factor for an elevated J-CTO score. It suggests that the TyG index may serve as a significant biomarker for predicting the need for revascularization and for long-term prognostic evaluation.