Triglyceride-glucose index as a predictor of adverse cardiovascular events in patients with in-stent restenosis following percutaneous coronary intervention

The Triglyceride-glucose index(TYG) is a reliable indicator for predicting the prognosis of patients with coronary heart disease after percutaneous coronary intervention (PCI). In patients with stent failure, its influence is unclear. This study was designed to evaluate the association between the TYG index and the occurrence of major adverse cardiovascular events (MACEs) after PCI in patients with in-stent restenosis(ISR).This retrospective study included 1,654 patients who underwent PCI from 2016 to 2023 in Nanjing First Hospital. Patients were stratified into three groups based on their quantile level. The baseline characteristics and follow-up data of these patients were meticulously recorded. The TyG index was determined as Ln(triglycerides [mg/dL] × fasting plasma glucose [mg/dL]/2.As a result, during a median follow-up period of 40 months, 357 patients (21.6%) experienced MACEs. After adjustment for potential confounders, There’ s significant and independent association between TYG index and the primary endpoint. (HR 1.191; 95% CI 1.019–1.412; P = 0.029). Compared to the lowest quantile, the risk of primary endpoint events in the TyG third quantile increased 1.370-fold (HR 1.370; 95% CI 1.052–1.785; P = 0.020). For the male and diabetes subgroups, this trend was even more pronounced (HR 1.269; 95% CI 1.055–1.527; P = 0.011; HR 1.385; 95% CI 1.125–1.706; P = 0.002). Additionally, the incidence of MACEs was greater in ISR patients with the highest TyG indices (P = 0.019).In conclusion, an increased TYG index is significantly associated with an increased risk of MACEs after PCI in patients with ISR, and this trend is more significant in male patients with diabetes. Monitoring TyG index is helpful for improving the postoperative health of patients with ISR.