A per-unit increase in the triglyceride-glucose index was associated with a 42% increased risk of cardiovascular events (HR 1.42) in patients undergoing complex percutaneous coronary intervention.
Cohort (n=9,154)
No
Does the TyG index predict cardiovascular events in patients undergoing complex PCI?
The TyG index is a suitable non-insulin-based insulin resistance marker that independently predicts cardiovascular events in patients undergoing complex PCI, improving risk stratification beyond traditional scores.
Effect estimate: HR 1.42 (95% CI 1.13-1.77)
p-value: p=0.002
BACKGROUND: Insulin resistance (IR), a hallmark of proceeding diabetes and cardiovascular (CV) disease, has been shown to predict prognosis in patients undergoing percutaneous coronary intervention (PCI). The triglyceride-glucose (TyG) index, triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio and metabolic score for insulin resistance (METS-IR) have been shown to be simple and reliable non-insulin-based surrogates for IR. However, limited studies have determined the associations between distinct non-insulin-based IR markers and CV outcomes in patients undergoing complex PCI who are at higher risk of CV events after PCI. Therefore, this study aimed to investigate and compare the prognostic value of these markers in patients undergoing complex PCI. METHODS: This was a descriptive cohort study. From January 2017 to December 2018, a total of 9514 patients undergoing complex PCI at Fuwai Hospital were consecutively enrolled in this study. The 3 IR indices were estimated from the included patients. The primary study endpoint was CV events, defined as a composite of CV death, nonfatal myocardial infarction and nonfatal stroke. RESULTS: During a median follow-up of 3.1 years, 324 (3.5%) CV events occurred. Multivariable Cox regression models showed per-unit increase in the TyG index (hazard ratio HR, 1.42; 95% confidence interval CI 1.13-1.77), rather than per-unit elevation in either Ln(TG/HDL-C ratio) (HR, 1.18; 95%CI 0.96-1.45) or METS-IR (HR, 1.00; 95%CI 0.98-1.02), was associated with increased risk of CV events. Meanwhile, adding the TyG index to the original model led to a significant improvement in C-statistics (0.618 vs. 0.627, P 0.05) to the original model. CONCLUSIONS: The TyG index, not TG/HDL-C ratio and METS-IR, was positively associated with worse CV outcomes in patients undergoing complex PCI. Our study, for the first time, demonstrated that the TyG index can serve as the suitable non-insulin-based IR marker to help in risk stratification and prognosis in this population.
He et al. (Sat,) conducted a cohort in Coronary artery disease undergoing complex percutaneous coronary intervention (n=9,154). Triglyceride-glucose (TyG) index vs. TG/HDL-C ratio and METS-IR was evaluated on Cardiovascular events (composite of CV death, nonfatal myocardial infarction, and nonfatal stroke) (HR 1.42, 95% CI 1.13-1.77, p=0.002). A per-unit increase in the triglyceride-glucose index was associated with a 42% increased risk of cardiovascular events (HR 1.42) in patients undergoing complex percutaneous coronary intervention.