Coronary Artery Calcification and Triglyceride-Glucose Index

Abstract

Coronary artery calcification (CAC) represents a key marker of subclinical atherosclerosis and is widely used for cardiovascular risk stratification. As a non-invasive, quantifiable indicator assessed by computed tomography, the CAC score reflects the cumulative burden of atherosclerotic plaque and strongly predicts coronary events beyond traditional cardiovascular risk factors. Individuals with elevated CAC scores have significantly higher risks of myocardial infarction, coronary revascularization, and cardiovascular mortality. In recent years, metabolic indices have gained attention as simple yet powerful tools for predicting cardiometabolic risk. The triglyceride-glucose (TyG) index calculated from fasting triglyceride and glucose levels has emerged as a reliable surrogate marker of insulin resistance. It is strongly associated with endothelial dysfunction, arterial stiffness, and the development of atherosclerosis. Several studies suggest that higher TyG index values correlate with increased coronary artery disease (CAD) severity, adverse plaque characteristics, and higher CAC burden. Understanding the relationship between TyG index and CAC is clinically important because both indices are inexpensive, widely accessible, and easily reproducible in routine practice. Investigating their association may support early identification of high-risk individuals, optimize preventive strategies, and improve cardiovascular outcomes.