Key result
In nondiabetic patients with acute coronary syndrome and LDL-C below 1.8 mmol/L, a high triglyceride-glucose index (≥8.33) was associated with a significantly higher risk of subsequent revascularization (HR 1.67).
Why the study?
The prognostic value of the triglyceride-glucose (TyG) index in nondiabetic patients with ACS and LDL-C below 1.8 mmol/L was unknown.
Does a high Triglyceride-Glucose (TyG) index predict poor cardiovascular outcomes in nondiabetic patients with ACS and LDL-C < 1.8 mmol/L?
Cohort (n=1,655)
No
Does a high Triglyceride-Glucose (TyG) index predict poor cardiovascular outcomes in nondiabetic patients with ACS and LDL-C < 1.8 mmol/L?
Effect estimate: HR 1.67 (95% CI 1.02-2.75)
Absolute Event Rate: 8.9% vs 5%
p-value: p=0.043
In nondiabetic patients with ACS and well-controlled LDL-C, a high TyG index is an independent predictor of subsequent revascularization and larger infarct size.
High TyG index may refine revascularization risk stratification in nondiabetic ACS with low LDL-C; leaves open whether targeting it improves outcomes.
AIM: To evaluate the prognostic value of triglyceride-glucose (TyG) index in nondiabetic patients with acute coronary syndrome (ACS) with low-density lipoprotein cholesterol (LDL-C) below 1.8 mmol/L. METHODS: A total of 1655 nondiabetic patients with ACS with LDL-C below 1.8 mmol/L were included in the analysis. Patients were stratified into two groups. The incidence of acute myocardial infarction (AMI), infarct size in patients with AMI, and major adverse cardiac and cerebral event during a median of 35.6-month follow-up were determined and compared between the two groups. The TyG index was calculated using the following formula: ln [fasting triglycerides (mg/dL)×fasting plasma glucose (mg/dL)/2]. RESULTS: Compared with the TyG index ＜8.33 group, the TyG index ≥ 8.33 group had a significantly higher incidence of AMI (21.2% vs. 15.2%, p=0.014) and larger infarct size in patients with AMI [the peak value of troponin I: 10.4 vs. 4.8 ng/ml, p=0.003; the peak value of Creatine kinase MB: 52.8 vs. 22.0 ng/ml, p=0.006; the peak value of myoglobin: 73.7 vs. 46.0 ng/ml, p=0.038]. Although there was no significant difference in mortality between the two groups, the incidence of revascularization of the TyG index ≥ 8.33 group was significantly higher than that of the TyG index ＜8.33 group (8.9% vs. 5.0%, p=0.035). A multivariable Cox regression revealed that the TyG index was positively associated with revascularization [hazard ratio, 1.67; 95% confidence interval, 1.02-2.75; p=0.043]. CONCLUSIONS: In nondiabetic patients with ACS with LDL-C below 1.8 mmol/L, a high TyG index level was associated with higher incidence of AMI, larger infarct size, and higher incidence of revascularization. A high TyG index level might be a valid predictor of subsequent revascularization.
No takes yet. Share an insight, caveat, or question.
Zhang et al. (2021) conducted a cohort in Acute coronary syndrome (ACS) with LDL-C below 1.8 mmol/L in nondiabetic patients (n=1,655). High triglyceride-glucose (TyG) index (≥8.33) vs. Low TyG index (<8.33) was evaluated on Revascularization (HR 1.67, 95% CI 1.02-2.75, p=0.043). In nondiabetic patients with acute coronary syndrome and LDL-C below 1.8 mmol/L, a high triglyceride-glucose index (≥8.33) was associated with a significantly higher risk of subsequent revascularization (HR 1.67).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: