What is the clinical evidence from this study?

Study design: Cohort. Population: Critically ill patients with heart disease (n=4839). Intervention: Triglyceride-Glucose (TyG) Index vs. Lowest TyG quartile (Quartile 1: TyG <8.51). Primary outcome: In-hospital mortality (OR 1.83, 95% CI 1.27, 2.64, p=<0.001).

July 21, 2022Open Access

Triglyceride-Glucose Index Linked to In-Hospital Mortality in Critically Ill Patients with Heart Disease

Q: What are the key findings of this study?

A higher Triglyceride-Glucose (TyG) index was independently associated with an increased risk of in-hospital mortality in critically ill patients with heart disease (OR 1.83 for the highest versus lowest quartile).

Key Result

A higher Triglyceride-Glucose (TyG) index was independently associated with an increased risk of in-hospital mortality in critically ill patients with heart disease (OR 1.83 for the highest versus lowest quartile).

Study Design

Type

Cohort (n=4,839)

Multicenter

Structured PICO

Does a higher triglyceride-glucose (TyG) index predict in-hospital mortality in critically ill patients with heart disease?

Population

4,839 critically ill adult patients with heart disease admitted to the intensive care unit for at least 2 days, evaluated for in-hospital mortality.

Exposure

Higher triglyceride-glucose (TyG) index quartiles

Comparator

Lowest triglyceride-glucose (TyG) index quartile (Quartile 1)

Outcome

In-hospital mortalityhard clinical

The triglyceride-glucose index is an independent predictor of in-hospital mortality in critically ill patients with heart disease, offering a simple prognostic marker for this high-risk population.

Main Result

Odds Ratio: 1.83 (95% CI 1.27–2.64)

Absolute Event Rate: 12.1% vs 5.3%

p-value: p=<0.001

Limitations

Single-center retrospective cohort study design introduces selection and recall bias
Causal relationship cannot be determined
Severity for each kind of heart disease could not be stratified
Cause-of-death data was unavailable
Small sample size of patients with diabetes reduced model accuracy
Unable to demonstrate whether treatment to reduce TyG relates to a lower incidence of adverse clinical outcomes

Abstract

Background: As an alternative method to evaluate insulin resistance (IR), triglyceride-glucose index (TyG) was shown to be related to the severity and prognosis of cardiovascular diseases. The main aim of this study was to explore the association between TyG and in-hospital mortality in critically ill patients with heart disease. Method: The calculation method of TyG has been confirmed in previous report: Ln fasting TGs (mg/dL) × FBG (mg/dL)/2. All patients were divided into four different categories according to TyG quartiles. Primary outcome was in-hospital mortality. Binary logistic regression analysis was performed to determine the independent effect of TyG. Result: 4839 critically ill patients with heart disease were involved. The overall mortality was 8.53 cases per 100 idviduals. In-hospital mortality increased as TyG quartiles increased (Quartile 4 vs Quartile 1: 12.1 vs 5.3, p < 0.001). Even after adjusting for confounding variables, TyG was still independently associated with the increased risk of in-hospital mortality in critically ill patients with heart disease (Quartile 4 vs Quartile 1: OR (95% CI): 1.83 (1.27, 2.64), p < 0.001, P for trend <0.001). In the subgroup analysis, we failed to observe the association between increased TyG and the risk of mortality in patients complicated by diabetes. In addition, as TyG quartiles increased, the length of intensive care unit (ICU) stay was prolonged (Quartile 4 vs Quartile 1: 2.3 (1.3, 4.9) vs 2.1 (1.3, 3.8), p = 0.007). And the significant interactions were not found in most subgroups. Conclusions: TyG was independently correlated with in-hospital mortality in critically ill patients with heart disease.

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