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High triglyceride-glucose index is associated with adverse cardiovascular outcomes in patients with acute myocardial infarction
Affiliation:1. Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China;2. Clinical Atherosclerosis Research Lab, Division of Cardiology, University of Washington, Seattle, WA, USA;3. Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease, Beijing, China;4. Department of Geriatrics, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Abstract:Background and aimsTriglyceride glucose (TyG) index is considered a new surrogate marker of insulin resistance that associated with the development of vascular disease. The aim of this study was to evaluate the prognostic value of TyG index in patients with acute myocardial infarction (AMI).Methods and resultsA total of 3181 patients with AMI were included in the analysis. Patients were stratified into 2 groups according to their TyG index levels: the TyG index <8.88 group and the TyG index ≥8.88 group. The incidence of major adverse cardiovascular events (MACEs) during a median of 33.3-month follow-up were recorded. Multivariable Cox regression models revealed that the TyG index was positively associated with all-cause death [HR (95% CI): 1.51 (1.10,2.06), p = 0.010], cardiac death [HR (95% CI): 1.68 (1.19,2.38), p = 0.004], revascularization [HR (95% CI): 1.50 (1.16,1.94), p = 0.002], cardiac rehospitalization [HR (95% CI): 1.25 (1.05,1.49), p = 0.012], and composite MACEs [HR (95% CI): 1.19 (1.01,1.41), p = 0.046] in patients with AMI. The independent predictive effect of TyG index on composite MACEs was mainly reflected in the subgroups of male gender and smoker. The area under the curve (AUC) of the TyG index predicting the occurrence of MACEs in AMI patients was 0.602 [95% CI 0.580,0.623; p < 0.001].ConclusionHigh TyG index levels appeared to be associated with an increased risk of MACEs in patients with AMI. The TyG index might be a valid predictor of cardiovascular outcomes of patients with AMI.Trial registrationRetrospectively registered.
Keywords:Insulin resistance (IR)  Triglyceride-glucose index (TyG index)  Acute myocardial infarction (AMI)  Major adverse cardiovascular events (MACEs)  AMI"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0035"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  acute myocardial infarction  IR"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0045"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  insulin resistance  HOMA-IR"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0055"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  the homeostasis model assessment of insulin resistance  TGs"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0065"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  triglycerides  TyG"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0075"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  triglyceride-glucose index  FPG"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0085"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  fasting plasma glucose  HbA1c"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0095"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  glycated hemoglobin  MACCEs"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0105"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  major adverse cardiovascular and cerebrovascular events  PCI"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0115"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  percutaneous coronary intervention  STEMI"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0125"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  ST-elevation myocardial infarction  NSTE-ACS"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0135"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Non-ST-segment elevation acute coronary syndrome  MACEs"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0145"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  major adverse cardiovascular events  NSTEMI"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0155"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Non-ST-segment elevation myocardial infarction  BMI"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0165"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  body mass index  WBC"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0175"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  white blood cell  eGFR"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0185"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  estimated glomerular filtration rate  TC"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0195"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  total cholesterol  LDL-C"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0205"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  low-density lipoprotein cholesterol  HDL-C"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0215"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  high-density lipoprotein cholesterol  LVEF"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0225"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  left ventricular ejection fraction  LM"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0235"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  left main  CABG"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0245"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  coronary artery bypass graft  SBP"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0255"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  systolic blood pressure
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