EXPRESS: Investigation into the Significance of CCTA-FFR, TyG Index, and NLR in Assessing the Stenosis Degree of Coronary Atherosclerosis

Background: This study aimed to investigate the predictive significance of fractional flow reserve derived from coronary computed tomography angiography (CCTA-FFR), lipid profiles, the triglyceride glucose (TyG) index, and the neutrophil-to-lymphocyte ratio (NLR) in assessing the degree of coronary atherosclerosis stenosis. Methods: This retrospective study analyzed data from 80 patients with CHD (aged ≥55 years) who underwent CCTA. Participants were stratified into two groups using the Gensini scoring system: mild stenosis（MS）and moderate-to-severe stenosis (M-SS). Comprehensive comparisons were performed on baseline characteristics, CCTA-derived parameters (including CT-FFR and coronary artery calcium CAC scores), metabolic markers (fasting lipid profiles, TyG index), and systemic inflammatory indicators the ratio of platelet to lymphocyte (PLR), the ratio of monocyte to lymphocyte (MLR) and NLR. Results: The M-SS group exhibited significantly elevated Gensini scores (28.65±2.32 vs. 21.34±3.48, p<0.001), CAC scores (25.14±4.86 vs. 22.73±3.66, p<0.01), the TyG index (9.49±1.38 vs. 8.61±1.11, p<0.001), and NLR (3.12±0.96 vs. 2.69±0.73, p<0.02) compared with the MS group. In contrast, the CCTA-FFR value of MS group was significantly higher than of M-SS group. Notable inverse correlations were identified between CCTA-FFR and both Gensini scores and CAC scores. Moreover, NLR and the TyG index displayed positive correlations with Gensini scores and CAC scores. Conclusions: The integration of CCTA-FFR, the TyG index, and NLR provides a comprehensive tool to assess coronary stenosis severity in elderly patients with CHD. These findings highlight their potential use in risk stratification and personalized treatment planning.