Triglyceride glucose index and a reliable alternative marker of insulin resistance and an independent predictor of major adverse cardiovascular events (MACEs), which was defined as the composite of total death, myocardial infarction, coronary revascularization, stroke, and hospitalization because of heart failure.

We hypothesis that there is a relation between prediction of MACE in acute coronary syndrome patients and between triglyceride glucose index.

Cardiovascular diseases, particularly coronary artery disease (CAD), is considered as a main cause of death and disability in the developed countries as its responsible for about 1 in every 5 deaths In the last few years.

Acute coronary syndrome (ACS), which is the most severe ischemic heart disease including Non-ST-elevation myocardial infarction (NSTEMI), ST-elevation MI (STEMI), and unstable angina has been one of the leading causes of death worldwide which leads to a large social and economic burden.

It has been well recognized that the development of (CAD) is driven by multiple factors including glycemic abnormality and lipid disorders.

Insulin resistance (IR) is a key metabolic abnormality leading to the development of T2DM, and recent studies have also found that it could independently predict the development of cardiovascular disease (CVD). Hyperinsulinemic-Euglycemic Clamp (HIEC), as the gold standard for the diagnosis of insulin resistance, is very difficult to be carried out in clinical work due to its difficulty of operation and equipment requirements.

Triglyceride and glucose index (TyG index) was one of the alternative methods for evaluating insulin resistance and is a novel marker Unlike the homeostasis model assessment and quantitative insulin sensitivity check index, insulin is not included in the TyG index and a reliable alternative marker of insulin resistance and an independent predictor of major adverse cardiovascular events (MACEs), which was defined as the composite of total death, myocardial infarction, coronary revascularization, stroke, and hospitalization because of heart failure.

The TyG index was calculated as the ln (fasting triglyceride level [mg/dL] × fasting glucose level [mg/dL]/2) Normal cut-off values reported for the TyG in the literature are roughly around 4 and 8.

Aim of the work

To study the value of triglyceride glucose index as a short term predictor of MACE in diabetic and non diabetic patients presented by Acute coronary syndrome.

Inclusion Criteria:

• acute coronary syndrome patients

Exclusion Criteria:

• With acute infectious disease, rheumatic disease, hematological disease, or neoplastic disease.
• With severe valvulopathy or cardiomyopathy
• Lacking clinical or follow-up data.
• suspected familial hypertriglyceridemia

Patients admitted by acute coronary syndrome in coronary care unit