Association of triglyceride glucose index with mortality in critically ill patients with atherosclerotic cardiovascular disease: analysis of the MIMIC-IV database

Figures

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  Fig. 1. Flowchart for participants from the MIMIC-IV (v 3.1). MIMIC-IV Medical Information Mart for Intensive Care IV, ASCVD atherosclerotic cardiovascular disease, ICU intensive care unit

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  Fig. 2. Restricted cubic spline (RCS) curves illustrating the multivariable-adjusted hazard ratios for all-cause mortality at A 30 days, B 90 days, and C 365 days according to TyG index levels. The solid red lines represent hazard ratios derived from Cox regression models, adjusted for potential confounders including age, sex, race, weight, hypertension, diabetes, congestive heart failure, atrial fibrillation, renal disease, chronic pulmonary disease, heart rate, potassium, creatinine, hemoglobin, platelets, mean arterial pressure, betablockers, statin, and international normalized ratio. Shaded areas denote 95% confidence intervals. Knots were placed at the 5th, 35th, 65th, and 95th percentiles of TyG distribution. The horizontal dashed line represents a hazard ratio of 1.0 (reference), anchored at the median TyG value. The top and bottom 0.5% of TyG index were excluded to reduce the influence of extreme values

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  Fig. 3. Kaplan–Meier survival curves for all-cause mortality stratified by TyG tertiles. A 30-day mortality; B 90-day mortality; C 365-day mortality

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  Fig. 4. Subgroup analyses of the association between TyG index and all-cause mortality at A 30 days, B 90 days, and C 365 days. Exploratory post hoc subgroup analyses were performed using multivariable-adjusted Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) across key clinical subgroups, including age, sex, race, hypertension, diabetes, and statin use. Adjustments were made for age, sex, race, weight, hypertension, diabetes, congestive heart failure, atrial fibrillation, renal disease, chronic pulmonary disease, heart rate, potassium, creatinine, hemoglobin, platelets, mean arterial pressure, betablockers, statin, and international normalized ratio. P-values for interaction were calculated to assess potential effect modification

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  Fig. 5. Mediation analysis of the association between TyG index and all-cause mortality at A 30 days, B 90 days, and C 365 days. The pathway diagrams illustrate the mediating effect of white blood cell (WBC) count on the association between TyG index and short-, intermediate-, and long-term mortality risk. The analysis was adjusted for age, sex, race, weight, hypertension, diabetes, congestive heart failure, atrial fibrillation, renal disease, chronic pulmonary disease, heart rate, potassium, creatinine, hemoglobin, platelets, mean arterial pressure, betablockers, statin, and international normalized ratio. All proportions and P-values for mediation are indicated in the diagrams, demonstrating that WBC partially mediates the relationship between TyG and mortality across different time frames