Prognostic value of the triglyceride-glucose index for major adverse events in acute aortic dissection patients

Background The prognostic value of insulin resistance (IR) indices in patients with acute aortic dissection (AAD) remains unclear. This study investigated the associations between four IR indices and major adverse cardiac and cerebrovascular events (MACCEs) in AAD patients. Methods We retrospectively analyzed 114 AAD patients from Henan Chest Hospital (December 2017-December 2023). Four IR indices were calculated: triglyceride-glucose (TyG) index, TyG-BMI index, TG/HDL-C ratio, and METS-IR. Multivariable logistic regression models were constructed to evaluate associations with MACCEs. Subgroup analyses were performed in male, hypertensive, diabetic, and smoking patients. Results Among 114 patients (mean age 50.67 ± 12.49 years), 55 (48.2%) developed MACCEs. In fully adjusted models, only TyG index independently predicted MACCEs (OR = 2.46, 95% CI: 1.24–4.90, p = 0.010). Subgroup analyses revealed robust associations in male patients (OR = 2.87, 95% CI: 1.24–6.65, p = 0.014) and smokers (OR = 3.13, 95% CI: 1.05–9.31, p = 0.040), but not in hypertensive patients. Conclusions An elevated TyG index independently predicts MACCEs in AAD patients, particularly in males and smokers, and may support risk stratification and intensified follow-up in high-risk individuals.