Prognostic value of triglyceride-glucose index in patients with cardiovascular-kidney-metabolic syndrome undergoing percutaneous coronary intervention

Background The triglyceride-glucose (TyG) index demonstrates strong links to heightened cardiovascular risk and progressive renal dysfunction. However, its prognostic implications in individuals diagnosed with cardiovascular-kidney-metabolic (CKM) syndrome who underwent Percutaneous Coronary Intervention (PCI) have yet to be fully elucidated. Methods A retrospective investigation was conducted involving CKM patients who underwent PCI between January 2014 and September 2017. The TyG index categories were established utilizing X-tile software for classification purposes. The principal endpoints comprised 5-year all-cause mortality (ACM) and cardiac mortality (CM). Associations between the TyG index and ACM/CM were evaluated using Cox proportional hazards models, and further examined through restricted cubic spline (RCS) analyses. Results Of the 2,040 patients analyzed, 1,186 (58.14%) were male and 854 (41.86%) female, with 55.83% aged ≥65 years. After analysis with multivariate Cox regression, elevated TyG index measurements demonstrated a notable association with heightened probabilities of ACM and CM occurrence. In comparison to the medium TyG index group, individuals categorized within the low TyG index group exhibited markedly elevated risks for ACM [hazard ratio [HR] = 1.82, 95% confidence interval [95%CI]: 1.15–2.88] and CM (HR = 2.68, 95%CI: 1.32–5.43). Additionally, a higher ACM risk was noted in the high TyG index group (HR = 1.39, 95%CI: 1.01–1.92). The RCS analysis identified no nonlinear association between the TyG index and either outcome ( P -values for nonlinearity test: 0.177 and 0.153, respectively). Conclusions The TyG index independently predicted increased risks of all-cause and cardiac mortality, thus highlighting its utility for risk stratification in CKM syndrome patients following PCI.