To evaluate the significance of the Triglyceride index and TG/HDL-C ratio as predictors of acute coronary syndromes in the young population

Cardiovascular disease (CVD) remains a major cause of morbidity and mortality worldwide, with a rising incidence of acute coronary syndromes (ACS) in young individuals under the age of 40. Early identification of at-risk individuals in this population is essential for implementing preventive strategies and reducing adverse outcomes【1,2】. Traditional risk factors such as hypertension, diabetes, smoking, and dyslipidemia are well-established; however, their predictive value in the young population is often limited【2】.

Recent studies have highlighted the significance of novel lipid-derived markers, particularly the triglyceride-glucose (TyG) index and the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio, as potential predictors of insulin resistance, subclinical atherosclerosis, and cardiovascular events【1,3】. The TyG index and TG/HDL-C ratio are simple, cost-effective markers derived from routine laboratory parameters and have shown promising associations with metabolic syndrome, endothelial dysfunction, and coronary artery disease (CAD) severity【3,4】.

Despite emerging evidence in older adults, limited data exist regarding the utility of these markers in predicting ACS among the young population, where conventional risk scores often underestimate risk【4,5】. Early detection through these markers could improve risk stratification and guide preventive strategies.

This study aims to evaluate the significance of the TyG index and TG/HDL-C ratio as predictors of ACS in young adults, providing insight into their potential role in primary prevention

Inclusion Criteria:

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Age 18-40 years. Confirmed diagnosis of ACS (STEMI, NSTEMI). Willingness to participate with informed consent.

Exclusion Criteria:

• Age > 40 years old People with Previous ACS Patients known to have familial hyperlipidemia

Young adult patients (18-45 years) admitted with acute coronary syndrome (STEMI, NSTEMI) who undergo coronary angiography during index hospitalization. Patients must have fasting lipid profile and fasting glucose measured within 24 hours of admission. Exclusions include familial hyperlipidemia, chronic inflammatory/autoimmune disease, severe renal or liver failure, active infection, recent use of non-statin lipid-altering drugs, or missing data for TyG/TG-HDL-C calculation. Follow-up will be conducted at 12 and 36 months to assess outcomes.