Association Between Low Triglyceride-Glucose Index and Mortality in Acute Decompensated Heart Failure Patients Without Diabetes

Background: The relationship between a low TyG index and mortality risk in Acute Decompensated Heart Failure (ADHF) also remains unclear. This study aimed to investigate the association between a low TyG index and 1-year mortality in ADHF patients without diabetes. Methods: A total of 652 hospitalized patients with ADHF without diabetes from January, 2020 to May, 2023 were included in this retrospective study. The primary outcomes were all-cause mortality and cardiovascular mortality within one year. The association between the TyG index and both all-cause and cardiovascular mortality was investigated using restricted cubic splines and multivariate Cox proportional hazards models. Results: The study enrolled a total of 652 patients with acute decompensated heart failure (ADHF) who were free from diabetes (70.6% male). Within one year, there were 72 deaths from all causes and 40 deaths from cardiovascular disease. In multivariate Cox proportional hazards models, a significant negative relationship was observed between the TyG index and both all-cause mortality (hazard ratio [HR] = 0.371, 95% confidence interval [CI] 0.201-0.685) and cardiovascular mortality (HR = 0.336, 95% CI 0.151-0.744). The restricted cubic spline analysis illustrated a decrease in the risk of all-cause and cardiovascular mortality as the TyG index increased. Hypertension, BMI, age, atrial fibrillation significantly interacted with the TyG index in relation to all-cause mortality, while hypertension specifically interacted with the TyG index regarding cardiovascular mortality. Conclusion: In patients diagnosed with ADHF without diabetes, a lower TyG index is strongly related to a higher risk of 1-year all-cause and cardiovascular mortality. Therefore, it is important to pay close attention to low TyG index levels and implement appropriate measures in clinical practice.