The role of triglyceride glucose index in predicting in-hospital adverse cardiovascular outcomes in patients with acute coronary syndrome

Abstract

Previous studies have shown the association of triglyceride glucose (TyG) index with metabolic syndrome (MetS), cardiovascular disease (CVD) and long-term adverse cardiovascular outcomes. However, to best our knowledge, the relation between the TyG index and in-hospital adverse cardiovascular outcomes in acute coronary syndrome (ACS) has not yet been reported. Hence, in this study, we aimed to evaluate the role of the TyG index in predicting in-hospital adverse cardiovascular outcomes in ACS and to compare its performance with the Global Acute Coronary 3Department of XXX, University of XXX, XXX Training and Research Hospital, City, Country Events Register (GRACE) risk score. 170 patients diagnosed with ACS and underwent coronary angiography were analyzed retrospectively. The 4Department of XXX, Faculty of XXX, City, Country TyG index was calculated using the following formula: ln [fasting triglycerides (mg/dL)×fasting blood glucose (mg/dL)/2]. Receiver operating characteristics (ROC) curve analysis was used to evaluate the performance of the TyG index and GRACE risk score in predicting in-hospital adverse cardiovascular outcomes. A binary logistic regression model was applied to determine the independent predictors for in-hospital adverse cardiovascular outcomes. At the initial analysis, patients with adverse cardiovascular outcomes had higher TyG index and GRACE risk score (p=0.011, p<0.001). In ROC curve analysis, the GRACE score performed better in predicting in-hospital adverse cardiovascular outcomes compared to TyG index (AUC:0.716, p<0.001; AUC:0.588, p=0.054 respectively). In binary logistic regression analysis, left ventricular ejection fraction (LVEF), multi-vessel disease and GRACE risk score were independent predictors for in-hospital adverse cardiovascular outcomes (OR: 0.840, 95% CI: 0.791-0.891, p<0.001; OR: 3.581, 95% CI:1.382-9.282, p=0.009; OR= 1.017, 95% CI: 1.001-1.034, p=0.04 respectively). Our study findings revealed that the TyG index was scant in predicting in-hospital adverse cardiovascular outcomes compared to GRACE risk score. The independent predictors for in-hospital adverse cardiovascular outcomes were LVEF, multivessel disease and GRACE risk score.