Association between triglyceride glucose–body mass index and clinical outcomes after septal myectomy

Aims This study examined the association between triglyceride glucose-body mass index (TyG–BMI) and clinical outcomes in patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing septal myectomy. Methods This retrospective cohort study was conducted at Fuwai Hospital, including 1,302 patients with HOCM who underwent septal myectomy. According to the tertile distribution of TyG–BMI, the participants were classified into three groups (T1–T3). The primary endpoint consisted of heart failure hospitalization or all-cause death. Results The mean age of the participants was 49.2 ± 11.8 years, of whom 61% (791) were men. During a median follow-up of 4.3 (3.1–6.2) years, the cumulative incidences of primary endpoint and all-cause death differed significantly across the three groups on the Kaplan–Meier analysis (log-rank P < 0.05). Cox analysis showed that patients in group T3 exhibited the greatest incidence rates of primary endpoint (adjusted hazard ratio (HR) = 2.00, 95% confidence interval (CI) 1.16–3.44, P = 0.012) as well as the highest risk of all-cause death (adjusted HR = 3.39, 95% CI 1.34–8.58, P = 0.010) compared to those in group T1. When treated as a continuous variable, TyG–BMI remained significantly linked to an elevated risk of primary endpoint (adjusted HR = 1.007, 95% CI 1.002–1.012, P = 0.009) and increased all-cause death (adjusted HR = 1.013, 95% CI 1.006–1.021, P = 0.001). Conclusions Higher TyG–BMI was associated with an increased risk of adverse long-term outcomes after septal myectomy in patients with HOCM.