Higher TyG index was associated with a 29-31% lower cardiovascular mortality risk (HR ~0.69-0.72), but not all-cause mortality, in 2,781 HCM patients over 57 months.
Is the triglyceride-glucose (TyG) index associated with all-cause and cardiovascular mortality in patients with hypertrophic cardiomyopathy?
The TyG index is associated with cardiovascular mortality in patients with hypertrophic cardiomyopathy, a relationship that is suppressed by uric acid levels.
Absolute Event Rate: 0% vs 0%
Abstract Background Insulin resistance is a key contributor to the pathogenesis of cardiovascular diseases. The triglyceride-glucose (TyG) index is a promising, noninvasive surrogate marker for insulin resistance. However, the relationship between the TyG index and prognosis in patients with hypertrophic cardiomyopathy (HCM) remains unclear. Purpose This study aimed to investigate the association of TyG index with all-cause and cardiovascular mortality in HCM patients. Methods This study identified HCM patients from 15 medical centers. The primary outcomes included all-cause mortality and cardiovascular mortality. Multivariable Cox regression analysis and restricted cubic splines were conducted to explore the associations between the TyG index and mortality. Multivariable competing risk analysis was used as sensitivity analysis. We conducted prespecified subgroup analyses stratified by gender, age, left ventricular outflow tract obstruction, pulmonary hypertension, and late gadolinium enhancement. Mediation analysis and multivariable linear regression analysis were employed to assess the mediating effect of mediator on the association between the TyG index and cardiovascular survival. Results A total of 2,781 patients were included. During a median follow-up of 57.34 months, 400 all-cause deaths and 226 cardiovascular deaths occurred. Multivariable Cox regression analysis revealed no significant association between the TyG index and all-cause mortality, but a lower TyG index was associated with reduced cardiovascular mortality (Model 1: hazard ratio (HR) 0.69, 95% confidence interval (CI) 0.55-0.87, P=0.001; Model 2: HR 0.71, 95% CI 0.56-0.91, P=0.005; Model 3: HR 0.72, 95% CI 0.57-0.92, P=0.007). Restricted cubic splines showed a decreasing trend in the risk of all-cause and cardiovascular mortality as the TyG index increased. Sensitivity analysis using a competing risk model confirmed the significant association with lower cardiovascular mortality. No significant interaction between subgroups was observed. Mediation analysis showed that uric acid (UA) suppressed the association between the TyG index and cardiovascular survival. TyG index was positively correlated with UA (β 25.36, Std Error 5.21, P0.001). Higher levels of lg(UA) were associated with increased cardiovascular mortality risk (HR 5.37, 95% CI 1.80-16.03, P=0.003). Conclusions A higer TyG index was associated with a lower risk of cardiovascular mortality, but not with all-cause mortality in HCM patients. TyG index was positively correlated with UA level, and UA suppressed the association between TyG index and cardiovascular survival.Multivariable Cox regression analysis Mediation analysis of uric acid
Zheng et al. (Sat,) reported a other. Higher TyG index was associated with a 29-31% lower cardiovascular mortality risk (HR ~0.69-0.72), but not all-cause mortality, in 2,781 HCM patients over 57 months.