Abstract
BackgroundInsulin resistance (IR) is considered a pivotal risk factor for cardiometabolic diseases, and the triglyceride–glucose index (TyG index) has emerged as a reliable surrogate marker of IR. Although several recent studies have shown the association of the TyG index with vascular disease, no studies have further investigated the role of the TyG index in acute ST-elevation myocardial infarction (STEMI). The objective of the present study was to evaluate the potential role of the TyG index as a predictor of prognosis in STEMI patients after percutaneous coronary intervention (PCI).MethodsThe study included 1092 STEMI patients who underwent PCI. The patients were divided into 4 quartiles according to TyG index levels. Clinical characteristics, fasting plasma glucose (FPG), triglycerides (TGs), other biochemical parameters, and the incidence of major adverse cardiovascular and cerebral events (MACCEs) during the follow-up period were recorded. The TyG index was calculated using the following formula: ln[fasting TGs (mg/dL) × FPG (mg/dL)/2].ResultsThe incidence of MACCEs and all-cause mortality within 30 days, 6 months and 1 year after PCI were higher among STEMI patients with TyG index levels in the highest quartile. The TyG index was significantly associated with an increased risk of MACCEs in STEMI patients within 1 year after PCI, independent of confounding factors, with a value of 1.529 (95% CI 1.001–2.061; P = 0.003) for those in the highest quartile. The area under the curve (AUC) of the TyG index predicting the occurrence of MACCEs in STEMI patients after PCI was 0.685 (95% CI 0.610–0.761; P = 0.001). The results also revealed that Killip class > 1, anaemia, albumin, uric acid, number of stents and left ventricular ejection fraction (LVEF) were independent predictors of MACCEs in STEMI patients after PCI (all P < 0.05).ConclusionsThis study indicated an association between higher TyG index levels and increased risk of MACCEs in STEMI patients for the first time, and the TyG index might be a valid predictor of clinical outcomes in STEMI patients undergoing PCI.Trial Registration ChiCTR1900024577.
Highlights
Insulin resistance (IR) is considered a pivotal risk factor for cardiometabolic diseases, and the triglyceride–glucose index (TyG index) has emerged as a reliable surrogate marker of IR
There were statistically significant differences (P < 0.05) among the four groups in terms of age, Body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, hypertension, diabetes mellitus (DM), platelets, albumin, fasting plasma glucose (FPG), measured HbA1c, TGs, total cholesterol (TC), high-density lipoprotein–cholesterol (HDL-C), low-density lipoprotein–cholesterol (LDL-C), uric acid, three-vessel disease, and Gensini score, and no statistically significant differences were found in the other indicators
The TyG index was positively correlated with BMI, SBP, DBP, heart rate, platelets, albumin, FPG, measured HbA1c, TGs, TC, HDL-C, LDL-C, uric acid, and Gensini score, while it was negatively related to age
Summary
Insulin resistance (IR) is considered a pivotal risk factor for cardiometabolic diseases, and the triglyceride–glucose index (TyG index) has emerged as a reliable surrogate marker of IR. Several recent studies have shown the association of the TyG index with vascular disease, no studies have further investigated the role of the TyG index in acute ST-elevation myocardial infarction (STEMI). Previous studies have shown that the TyG index is associated with coronary artery calcification, carotid atherosclerosis, symptomatic coronary artery disease and a high risk of CVD [15,16,17,18]. To the best of our knowledge, the relationship between TyG index levels and clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) has not been fully evaluated. The purpose of this study was to explore the predictive value of TyG index levels on the clinical outcomes of STEMI patients after PCI and to provide ideas for improving STEMI risk stratification
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