The triglycerides-glucose index and the triglycerides to high-density lipoprotein cholesterol ratio are both effective predictors of in-hospital death in non-diabetic patients with AMI.

Abstract

The triglycerides-glucose index (TyG) and the triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) are simple indicators for assessing insulin resistance in epidemiological studies. We aimed to clarify the relationship between indicators of insulin resistance and prognosis in non-diabetic acute myocardial infarction (AMI) patients. A total of 1,648 AMI patients without diabetes were enrolled from the Department of Cardiology, Zhongda Hospital, between 2012.03 and 2018.12. The medical history, laboratory and imaging data of patients were collected through the medical record system, and all-cause death events were recorded. Pearson analysis was used to study the correlation among different variables. Logistic regression analysis was used to analyze the predictive effect of TyG and TG/HDL-C in in-hospital death of AMI patients. 1. In AMI group, the TyG index was significantly increased in death groups compared to no-death groups (P=0.025). TG/HDL-C was not significantly increased in the death group of AMI patients (P=0.588). The patients were respectively divided into Q1-Q4 groups and T1-T4 groups according to the quartiles of TyG and TG/HDL-C. The trends of in-hospital mortality in the Q4 group of TyG and T4 group of TG/HDL-C were higher than in other groups, although these differences were not significant. 2. Pearson correlation analysis showed that TyG was positively correlated with lipid-related markers, including ApoB (r=0.248, P<0.001), total cholesterol (TC) (r=0.270, P<0.001), low-density lipoprotein cholesterol (LDL-C) (r=0.238, P<0.001). Spearman analysis showed that TG/HDL-C was also positively associated with TC (r=0.107, P<0.001), ApoB (r=0.180, P<0.001) and LDL-C (r=0.164, P<0.001). 3. Logistic regression analysis showed that TyG (OR = 3.106, 95% CI [2.122-4.547], P<0.001) and TG/HDL-C (OR = 1.167, 95% CI [1.062-1.282], P=0.001) were both important factors to predict the in-hospital death of AMI patients without diabetes. TyG index and TG/HDL-C, as emerged simple markers of insulin resistance, were both important predictors of in-hospital death in AMI patients without diabetes.