Abstract
BackgroundTriglyceride-glucose (TyG) index is a reliable and specific biomarker for insulin resistance and is associated with renal dysfunction. The present study sought to explore the relationship between TyG index and the incidence of contrast-induced nephropathy (CIN) in non-ST elevation acute coronary syndrome (NSTE-ACS) patients implanted with drug-eluting stents (DESs).MethodsA total of 1108 participants were recruited to the study and assigned to two groups based on occurrence of CIN. TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. Baseline characteristics and incidence of CIN were compared between the two groups. Logistic regression analysis was performed to evaluate the relationship between TyG index and CIN.ResultsThe results showed that 167 participants (15.1%) developed CIN. Subjects in the CIN group had a significantly higher TyG index compared with subjects in the non-CIN group (8.9 ± 0.7 vs. 9.3 ± 0.7, P<0.001). TyG index was significantly correlated with increased risk of CIN after adjusting for confounding factors irrespective of diabetes mellitus status and exhibited a J-shaped non-linear association. Subgroup analysis showed a significant gender difference in the relationship between TyG index and CIN. Receiver operating characteristic (ROC) curve analysis indicated that the risk assessment performance of TyG index was superior compared with other single metabolic indexes. Addition of TyG index to the baseline model increased the area under the curve from 0.713 (0.672-0.754) to 0.742 (0.702-0.782) and caused a reclassification improvement of 0.120 (0.092-0.149).ConclusionThe findings from the present study show that a high TyG index is significantly and independently associated with incidence of CIN in NSTE-ACS patients firstly implanted with DESs. Routine preoperative assessment of TyG index can alleviate CIN and TyG index provides a potential target for intervention in prevention of CIN.
Highlights
Contrast-induced nephropathy (CIN) is defined as a decline in renal function occurring after intravascular administration of contrast agents [1]
Participants presenting with CIN exhibited a higher prevalence of hypertension, diabetes mellitus, non-ST elevation myocardial infarction (NSTEMI), higher levels of leukocyte count, serum creatinine (SCr), preoperative estimated glomerular filtration rate (eGFR), fasting blood glucose (FBG), TG, total cholesterol (TC), and hemoglobin A1c (HbA1c), as well as higher proportion of multiple vessel disease and Gensini scores compared with non-CIN subjects
Participants in the CIN group received a higher dose of contrast agent but exhibited lower hydration rate and were more likely to undergo treatment with oral hypoglycemic drugs compared with subjects in non-CIN group
Summary
Contrast-induced nephropathy (CIN) is defined as a decline in renal function occurring after intravascular administration of contrast agents [1]. Studies should explore methods for risk stratification and effective preventive strategies to improve prognosis of CIN patients. Hyperinsulinemic-euglycemic clamp (HEC) test and homeostatic model assessment (HOMA) are effective methods for determination of IR [10, 11]. Recent studies reported a high correlation between HOMA-IR and HEC. TyG index is significantly associated with prevalence of diabetes, incidence of unstable carotid plaque, and adverse prognosis of cardiovascular diseases (CVD) [13,14,15]. Triglyceride-glucose (TyG) index is a reliable and specific biomarker for insulin resistance and is associated with renal dysfunction. The present study sought to explore the relationship between TyG index and the incidence of contrast-induced nephropathy (CIN) in non-ST elevation acute coronary syndrome (NSTE-ACS) patients implanted with drug-eluting stents (DESs)
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