Abstract
BackgroundThe relationship between triglyceride-glucose index (TyG index) and the prevalence and prognosis of cardiovascular disease has been confirmed by former studies. However, it remains uncertain whether TyG index has a prognostic impact in patients with type 2 diabetes mellitus (T2DM) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing percutaneous coronary intervention (PCI).MethodsThe study retrospectively enrolled 798 patients (mean age: 60.9 ± 8.3 years; 68.3% men) with T2DM and NSTE-ACS who underwent PCI at Beijing Anzhen Hospital from January to December 2015. TyG index was calculated as previously reported: ln [fasting TGs (mg/dL) * FBG (mg/dL)/2]. The primary endpoint was a composite of adverse events as follows: all-cause death, non-fatal myocardial infarction (MI) and ischemia-driven revascularization.ResultsTyG index was significantly higher in patients with a primary endpoint event compared with those without. Multivariate Cox proportional hazards analysis showed that 1-unit increase of TyG index was independently associated with higher risk of primary endpoint, independent of other risk factors [hazard ratio (HR) 3.208 per 1-unit increase, 95% confidence interval (CI) 2.400–4.289, P < 0.001]. The addition of TyG index to a baseline risk model had an incremental effect on the predictive value for adverse prognosis [AUC: baseline risk model, 0.800 vs. baseline risk model + TyG index, 0.856, P for comparison < 0.001; category-free net reclassification improvement (NRI) 0.346, P < 0.001; integrated discrimination improvement (IDI) 0.087, P < 0.001].ConclusionsIncreased TyG index is a significant predictor of adverse prognosis in patients with T2DM and NSTE-ACS undergoing PCI. Further studies need to be performed to determine whether interventions for TyG index have a positive impact on improving clinical prognosis.
Highlights
The relationship between triglyceride-glucose index (TyG index) and the prevalence and prognosis of cardiovascular disease has been confirmed by former studies
The triglyceride-glucose index (TyG index), which is derived from fasting triglycerides (TGs) and fasting blood glucose (FBG), has been proposed as a surrogate biomarker of Insulin resistance (IR) and former studies have proved that it has high correlation with hyperinsulinaemic-euglycaemic clamp, either in individuals with or without type 2 diabetes mellitus (T2DM) [11,12,13]
In our present study, we retrospectively investigated the predictive significance of IR assessed by TyG index for adverse prognosis in patients with T2DM and NSTEACS who were treated with percutaneous coronary intervention (PCI)
Summary
The relationship between triglyceride-glucose index (TyG index) and the prevalence and prognosis of cardiovascular disease has been confirmed by former studies. It remains uncertain whether TyG index has a prognostic impact in patients with type 2 diabetes mellitus (T2DM) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing percutaneous coronary intervention (PCI). Zhao et al Cardiovasc Diabetol (2020) 19:108 and revascularization having been widely developed and applied, the risk of recurrent adverse cardiovascular outcomes remains relatively high in patients with CAD, especially for those who have ever had an acute coronary syndrome (ACS) [1,2,3]. The association between TyG index and the prevalence and prognosis of cardiovascular disease has been confirmed by certain clinical researches, despite the existence of diabetes or not at baseline [17,18,19,20,21,22]
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