November 15, 2024Scientific Reports7 citationsOpen Access

Triglyceride-glucose index and hsCRP-to-albumin ratio as predictors of major adverse cardiovascular events in STEMI patients with hypertension

JHJinyong Huang JZJunyi Zhang LLLinjie Li

Structured PICO

Does a high TyG index combined with a high hsCAR predict an increased risk of major adverse cardiovascular events in patients with STEMI and hypertension?

Population

699 adults (aged ≥ 18 years) with ST-elevation myocardial infarction (STEMI) and hypertension who underwent coronary angiography/percutaneous coronary intervention (PCI), median age 66.0, 25.9% female, based in China. Key exclusions: prior myocardial infarction, prior PCI or CABG, severe hepatic or renal disease, active infection, and missing clinical data.

Intervention

High Triglyceride-glucose (TyG) index (≥ 7.8) and/or high high-sensitivity C-reactive protein-to-albumin ratio (hsCAR) (≥ 0.15)

Comparator

Low TyG index (< 7.8) and low hsCAR (< 0.15)

Outcome

Major adverse cardiovascular events (MACE), defined as a composite of all-cause death, nonfatal myocardial infarction, repeat revascularization, heart failure, stroke or transient cerebral ischemia during the follow-up period after PCIcomposite

The combination of the TyG index and hsCAR provides strong predictive power for major adverse cardiovascular events in patients with STEMI and hypertension, outperforming the traditional GRACE score.

Abstract

This study aimed to evaluate the association between the triglyceride-glucose (TyG) index and high-sensitivity C-reactive protein-to-albumin ratio (hsCAR) and the prognosis of patients with STEMI and hypertension. A total of 699 patients diagnosed with STEMI and hypertension were included in this study database. Compared to the low TyG index group (< 7.8), the high TyG index group (≥ 7.8) was associated with an increased risk of MACE (HR 2.09, 95% CI = 1.58-2.77; P < 0.001). Similarly, a higher hsCAR (≥ 0.15) was linked to an increased risk of MACE (HR 1.46, 95% CI = 1.12-1.90; P = 0.005). Subsequently, we categorized the population into four groups based on the defined cutoff points. Compared to the low TyG-low hsCAR subgroup, the other three subgroups demonstrated an elevated risk of MACE. Among patients treated with PCSK9 and SGLT2 inhibitors, the combined effect of the TyG index and hsCAR on MACE was attenuated. Finally, The combined TyG index and hsCAR model exhibited optimal performance (AUC = 0.71, 95% CI = 0.67-0.75; P < 0.001). This study demonstrates that the TyG index and hsCAR provide strong combined predictive power. The synergistic utilization offers a comprehensive approach to cardiovascular risk assessment.

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