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November 13, 2019Cardiovascular Diabetology357 citationsOpen Access

High triglyceride–glucose index is associated with poor prognosis in patients with acute ST-elevation myocardial infarction after percutaneous coronary intervention

ELErfei LuoCastle Hill HospitalDWDong WangChinese Academy of Medical Sciences & Peking Union Medical CollegeGYGaoliang YanSoutheast University

Key Result

A high triglyceride-glucose index in the highest quartile was significantly associated with an increased risk of major adverse cardiovascular and cerebral events within 1 year after PCI (OR 1.529).

Study Design

Type

Cohort (n=1,092)

Multicenter

No

Structured PICO

Does a high triglyceride-glucose (TyG) index predict an increased risk of MACCEs in STEMI patients undergoing PCI?

P
Population
1092 STEMI patients (aged 18-80 years) who underwent percutaneous coronary intervention (PCI), mean age 62.4, 79.1% male, based in China. Exclusions included history of major surgery, trauma or bleeding over the past 3 months; malignant tumour; serious injury of liver or kidney; contraindications to anticoagulant and antiplatelet therapy.
I
Intervention
High Triglyceride-Glucose (TyG) index (highest quartile, Q4: TyG index ≥ 9.608)
C
Comparator
Lower TyG index quartiles (Q1-Q3: TyG index < 9.608)
O
Outcome
Major adverse cardiovascular and cerebral events (MACCEs) including all-cause death, target vessel revascularization, myocardial infarction, unstable angina pectoris requiring hospitalization, heart failure, stroke or transient cerebral ischaemia at 1 year after PCIcomposite

A high triglyceride-glucose index is an independent predictor of major adverse cardiovascular and cerebral events in STEMI patients undergoing PCI.

Main Result

Effect estimate: OR 1.529 (95% CI 1.001-2.061)

p-value: p=0.003

Limitations

  • Restricted to a selected group of Chinese patients from one centre
  • Follow-up time might not be long enough
  • Use of hypoglycaemic treatment was not recorded
  • Changes in the TyG index during the follow-up period were not measured or analysed
  • Other confounding factors, such as cardiorespiratory fitness, nutritional data and exercise habits, were not included in the model

Abstract

BACKGROUND: Insulin resistance (IR) is considered a pivotal risk factor for cardiometabolic diseases, and the triglyceride-glucose index (TyG index) has emerged as a reliable surrogate marker of IR. Although several recent studies have shown the association of the TyG index with vascular disease, no studies have further investigated the role of the TyG index in acute ST-elevation myocardial infarction (STEMI). The objective of the present study was to evaluate the potential role of the TyG index as a predictor of prognosis in STEMI patients after percutaneous coronary intervention (PCI). METHODS: The study included 1092 STEMI patients who underwent PCI. The patients were divided into 4 quartiles according to TyG index levels. Clinical characteristics, fasting plasma glucose (FPG), triglycerides (TGs), other biochemical parameters, and the incidence of major adverse cardiovascular and cerebral events (MACCEs) during the follow-up period were recorded. The TyG index was calculated using the following formula: lnfasting TGs (mg/dL) × FPG (mg/dL)/2. RESULTS: The incidence of MACCEs and all-cause mortality within 30 days, 6 months and 1 year after PCI were higher among STEMI patients with TyG index levels in the highest quartile. The TyG index was significantly associated with an increased risk of MACCEs in STEMI patients within 1 year after PCI, independent of confounding factors, with a value of 1.529 (95% CI 1.001-2.061; P = 0.003) for those in the highest quartile. The area under the curve (AUC) of the TyG index predicting the occurrence of MACCEs in STEMI patients after PCI was 0.685 (95% CI 0.610-0.761; P = 0.001). The results also revealed that Killip class > 1, anaemia, albumin, uric acid, number of stents and left ventricular ejection fraction (LVEF) were independent predictors of MACCEs in STEMI patients after PCI (all P < 0.05). CONCLUSIONS: This study indicated an association between higher TyG index levels and increased risk of MACCEs in STEMI patients for the first time, and the TyG index might be a valid predictor of clinical outcomes in STEMI patients undergoing PCI. Trial Registration ChiCTR1900024577.

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Cite This Study

Luo et al. (2019) conducted a cohort in Acute ST-elevation myocardial infarction (STEMI) (n=1,092). High triglyceride-glucose (TyG) index (highest quartile) vs. Low triglyceride-glucose (TyG) index (lowest quartile) was evaluated on Major adverse cardiac and cerebrovascular events (MACCEs) within 1 year (OR 1.529, 95% CI 1.001-2.061, p=0.003). A high triglyceride-glucose index in the highest quartile was significantly associated with an increased risk of major adverse cardiovascular and cerebral events within 1 year after PCI (OR 1.529).

synapsesocial.com/papers/6a1b56cf664f78119642bb42https://doi.org/10.1186/s12933-019-0957-3
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