Key result
A higher triglyceride-glucose index was independently associated with an increased risk of major adverse cardiovascular events (HR 2.22) in nondiabetic patients after coronary artery bypass grafting.
Why the study?
Data are lacking on the relationship between the triglyceride-glucose index and prognosis in patients without diabetes mellitus who undergo coronary artery bypass grafting.
Does a higher triglyceride-glucose (TyG) index predict major adverse cardiovascular events in nondiabetic patients after coronary artery bypass grafting?
Cohort (n=830)
Yes
Does a higher triglyceride-glucose (TyG) index predict major adverse cardiovascular events in nondiabetic patients after coronary artery bypass grafting?
Hazard Ratio: 2.22 (95% CI 1.46–3.38)
Absolute Event Rate: 28.9% vs 14.1%
p-value: p=<0.001
Higher TyG index was associated with increased post-CABG MACE risk in nondiabetics; hypothesis-generating and requires prospective validation before clinical use.
BACKGROUND: The triglyceride-glucose (TyG) index has been evaluated as a reliable surrogate for insulin resistance (IR) and has been proven to be a predictor of poor outcomes in patients with cardiovascular diseases. However, data are lacking on the relationship of the TyG index with prognosis in nondiabetic patients who underwent coronary artery bypass grafting (CABG). Thus, the purpose of our current study was to investigate the potential value of the TyG index as a prognostic indicator in patients without diabetes mellitus (DM) after CABG. METHODS: This multicenter, retrospective cohort study involving 830 nondiabetic patients after CABG from 3 tertiary public hospitals from 2014 to 2018. Kaplan-Meier survival curve analysis was conducted followed by the log-rank test. Cox proportional hazards regression models were used to explore the association between the TyG index and major adverse cardiovascular events (MACEs). The incremental predictive power of the TyG index was evaluated with C-statistics, continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI). RESULTS: An incrementally higher TyG index was associated with an increasingly higher cumulative incidence of MACEs (log-rank test, p < 0.001). The hazard ratio (95% CI) of MACEs was 2.22 (1.46-3.38) in tertile 3 of the TyG index and 1.38 (1.18-1.62) per SD increase in the TyG index. The addition of the TyG index yielded a significant improvement in the global performance of the baseline model [C-statistic increased from 0.656 to 0.680, p < 0.001; continuous NRI (95% CI) 0.269 (0.100-0.438), p = 0.002; IDI (95% CI) 0.014 (0.003-0.025), p = 0.014]. CONCLUSIONS: The TyG index may be an independent factor for predicting adverse cardiovascular events in nondiabetic patients after CABG.
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Wu et al. (2023) conducted a cohort in Coronary artery disease without diabetes mellitus (n=830). Triglyceride-glucose (TyG) index vs. Lower TyG index (Tertile 1) was evaluated on Major adverse cardiovascular events (MACEs: composite of all-cause death, nonfatal MI, nonfatal stroke, and coronary artery revascularization) (HR 2.22, 95% CI 1.46-3.38, p=<0.001). A higher triglyceride-glucose index was independently associated with an increased risk of major adverse cardiovascular events (HR 2.22) in nondiabetic patients after coronary artery bypass grafting.
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