Key result
A triglyceride-glucose index ≥ 8.1 was the strongest independent predictor of the no-reflow phenomenon after percutaneous coronary intervention in STEMI patients with metabolic syndrome (OR 9.591).
Why the study?
The no-reflow phenomenon following PCI complicates clinical outcomes in acute STEMI, motivating the identification of a valuable predictor for this complication.
Does the TyG index predict the no-reflow phenomenon in STEMI patients with metabolic syndrome undergoing PCI?
Observational (n=378)
No
Does the TyG index predict the no-reflow phenomenon in STEMI patients with metabolic syndrome undergoing PCI?
Odds Ratio: 9.591 (95% CI 4.469–20.587)
p-value: p=<0.001
The triglyceride-glucose (TyG) index is a strong, independent predictor of the no-reflow phenomenon in patients with STEMI and metabolic syndrome undergoing PCI, offering a simple tool for risk stratification.
TyG index may aid no-reflow risk stratification in STEMI with metabolic syndrome; leaves open prospective validation before clinical adoption.
OBJECTIVE: Acute ST-segment elevation myocardial infarction (STEMI) remains a major contributor to morbidity and mortality worldwide. The no-reflow phenomenon following percutaneous coronary intervention (PCI) complicates the clinical outcome of STEMI. This study aimed to identify a valuable predictor for no-reflow phenomenon. METHODS: This retrospective study analyzed clinical data from 378 STEMI patients with metabolic syndrome who underwent PCI between January 2023 and December 2023. Patients were divided into normal reflow (n = 311) and no-reflow (n = 67) groups based on post-PCI coronary angiography results. Data collected included patient demographics, medication usage, lipid profiles, cardiac biomarkers, and the triglyceride-glucose (TyG) index. RESULTS: Patients in the no-reflow group were older (59.98 ± 3.45 vs. 58.69 ± 3.57 years, P = 0.007), with higher fasting glucose (118.57 ± 7.23 vs. 113.59 ± 7.62 mg/dL, P < 0.001) and triglycerides (185.36 ± 10.17 vs. 176.56 ± 10.38 mg/dL, P < 0.001). The TyG index was notably higher in the no-reflow group (8.97 ± 1.15 vs. 7.49 ± 1.17, P < 0.001), showing the strongest correlation with no-reflow (r = 0.420, P < 0.001). Receiver Operating Characteristic (ROC) analysis identified the TyG index as the best predictor, with an AUC of 0.818 at a threshold of 8.1. Multivariable logistic regression identified TyG index ≥ 8.1 as the strongest independent predictor of no-reflow (OR, 9.591; 95% CI, 4.469-20.587, P < 0.001). The AUC of the TyG for predicting no-reflow was 0.869, with specificity and sensitivity of 0.891 and 0.791, respectively. CONCLUSION: The TyG index is a powerful predictor of the no-reflow phenomenon in STEMI patients with metabolic syndrome undergoing PCI. Its robust sensitivity and specificity underscore its utility for risk stratification, enabling clinicians to identify high-risk patients and tailor preventive strategies.
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Zhi Qu (2024) conducted an observational in Acute ST-segment elevation myocardial infarction (STEMI) complicated by metabolic syndrome (n=378). Triglyceride-glucose (TyG) index ≥ 8.1 vs. TyG index < 8.1 was evaluated on No-reflow phenomenon after PCI (OR 9.591, 95% CI 4.469-20.587, p=<0.001). A triglyceride-glucose index ≥ 8.1 was the strongest independent predictor of the no-reflow phenomenon after percutaneous coronary intervention in STEMI patients with metabolic syndrome (OR 9.591).
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