An elevated triglyceride-glucose index (>8.70) significantly increased the risk of one-year all-cause mortality by 86% (HR 1.86) compared to lower levels in elderly patients hospitalized with acute decompensated heart failure.
Cohort (n=149)
No
Does an elevated triglyceride-glucose (TyG) index increase one-year mortality in elderly patients with acute decompensated heart failure?
The TyG index provides incremental prognostic value beyond conventional risk factors for predicting one-year mortality in elderly patients with acute decompensated heart failure.
Effect estimate: HR 1.86 (95% CI 1.03-3.37)
Absolute Event Rate: 44.9% vs 29.6%
p-value: p=0.04
Background The triglyceride-glucose (TyG) index, a simple surrogate marker of insulin resistance, has been associated with adverse cardiovascular outcomes. However, data on its prognostic value in elderly patients with acute decompensated heart failure (ADHF) are limited. This study aimed to evaluate the predictive role of the TyG index for one-year all-cause mortality in geriatric ADHF patients. Methods This retrospective single-center study included 149 patients aged ≥65 years who were hospitalized with ADHF between January 2023 and December 2024. The TyG index was calculated as ln fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2. Patients were stratified into quartiles based on TyG levels, and outcomes were compared across groups. Receiver operating characteristic (ROC) curves, Kaplan–Meier survival analysis, and multivariate Cox regression were applied to evaluate the prognostic performance of the TyG index. Results Higher TyG quartiles were significantly associated with increased glucose, triglyceride, and inflammatory marker levels ( p 0.05). ROC analysis demonstrated moderate discriminative ability for one-year mortality (AUC = 0.72, 95% CI: 0.61–0.83, p = 0.001), with an optimal cut-off value of 8.70. Kaplan–Meier curves showed significantly reduced survival in the highest TyG quartile (45.9%) compared with the lowest (89.5%) (log-rank p 0.001). Although TyG was not an independent predictor in multivariate analysis (HR 1.68; 95% CI: 0.70–4.00; p = 0.25), it was significant in the subgroup with left ventricular ejection fraction 40% (HR 1.91; 95% CI: 1.02–3.59; p = 0.04). Adding the TyG index to a conventional risk model including age, sex, left ventricular ejection fraction, hypertension, chronic obstructive pulmonary disease, cardiovascular disease, and chronic kidney disease significantly improved prognostic accuracy (NRI = 0.273, IDI = 0.011, both p 0.01). Conclusion Elevated TyG levels are associated with increased one-year mortality and reduced survival in elderly ADHF patients. The TyG index provides incremental prognostic value beyond conventional risk factors and in daily clinical practice may serve as a simple, low-cost tool for risk stratification in geriatric heart failure management.
Yilmaz et al. (Fri,) conducted a cohort in Acute decompensated heart failure (n=149). Elevated Triglyceride-Glucose (TyG) index (>8.70) vs. Low Triglyceride-Glucose (TyG) index (≤8.70) was evaluated on One-year all-cause mortality (HR 1.86, 95% CI 1.03-3.37, p=0.04). An elevated triglyceride-glucose index (>8.70) significantly increased the risk of one-year all-cause mortality by 86% (HR 1.86) compared to lower levels in elderly patients hospitalized with acute decompensated heart failure.