Triglyceride glucose index predicts in-hospital mortality in patients with ST-segment elevation myocardial infarction who underwent primary angiography.

OBJECTIVES To assess the correlation between triglyceride glucose (TyG) index and in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI). METHODS A total of 2190 patients with STEMI who underwent primary angiography within 12 h from symptom onset were selected from the prospective, nationwide, multicenter CAMI registry. TyG index was calculated with the formula: Ln [fasting triglycerides (mmol/L) × fasting glucose (mmol/L)/2]. Patients were divided into three groups according to the tertiles of TyG index. The primary endpoint was in-hospital mortality. RESULTS Overall, 46 patients died during hospitalization, in-hospital mortality was 1.5%, 2.2%, 2.6% for tertile 1, tertile 2, and tertile 3, respectively. However, TyG index was not significantly correlated with in-hospital mortality in single-variable logistic regression analysis. Nonetheless, after adjusting for age and sex, TyG index was significantly associated with higher mortality when regarded as a continuous variable (adjusted OR = 1.75, 95% CI: 1.16-2.63) or categorical variable (tertile 3 vs. tertile 1: adjusted OR = 2.50, 95% CI: 1.14-5.49). Furthermore, TyG index, either as a continuous variable (adjusted OR = 2.54, 95% CI: 1.42-4.54) or categorical variable (tertile 3 vs. tertile 1: adjusted OR = 3.57, 95% CI: 1.24-10.29), was an independent predictor of in-hospital mortality after adjusting for multiple confounders in multivariable logistic regression analysis. In subgroup analysis, the prognostic effect of high TyG index was more significant in patients with body mass index < 18.5 kg/m2 (P interaction = 0.006). CONCLUSIONS This study showed that TyG index was positively correlated with in-hospital mortality in STEMI patients who underwent primary angiography, especially in underweight patients.

[1]  Yundai Chen,et al.  Evaluation of the long-term prognostic ability of triglyceride-glucose index for elderly acute coronary syndrome patients: a cohort study , 2022, Cardiovascular Diabetology.

[2]  Da-zhuo Shi,et al.  Prognostic Significance of Triglyceride-Glucose Index for Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis , 2021, Frontiers in Cardiovascular Medicine.

[3]  F. Yalçin,et al.  Predictive Value of the SYNTAX Score for Diabetic Retinopathy in Stable Coronary Artery Disease Patients with a Concomitant Type 2 Diabetes Mellitus. , 2021, Diabetes research and clinical practice.

[4]  Meizi Cui,et al.  Triglyceride–glucose index and the incidence of atherosclerotic cardiovascular diseases: a meta-analysis of cohort studies , 2021, Cardiovascular Diabetology.

[5]  Cheng-gang Zhu,et al.  Triglyceride Glucose Index Is Associated With Arterial Stiffness and 10-Year Cardiovascular Disease Risk in a Chinese Population , 2021, Frontiers in Cardiovascular Medicine.

[6]  Yingfen Qin,et al.  U-shaped association between the triglyceride-glucose index and the risk of incident diabetes in people with normal glycemic level: A population-base longitudinal cohort study. , 2021, Clinical nutrition.

[7]  D. Berman,et al.  Quantitative assessment of coronary plaque volume change related to triglyceride glucose index: The Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging (PARADIGM) registry , 2020, Cardiovascular Diabetology.

[8]  Hui Gao,et al.  High triglyceride-glucose index is associated with adverse cardiovascular outcomes in patients with acute myocardial infarction. , 2020, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[9]  Hyuk-Jae Chang,et al.  Triglyceride glucose index is an independent predictor for the progression of coronary artery calcification in the absence of heavy coronary artery calcification at baseline , 2020, Cardiovascular Diabetology.

[10]  Jingjing Xu,et al.  Triglyceride-glucose index predicts adverse cardiovascular events in patients with diabetes and acute coronary syndrome , 2020, Cardiovascular Diabetology.

[11]  G. Yan,et al.  High triglyceride–glucose index is associated with poor prognosis in patients with acute ST-elevation myocardial infarction after percutaneous coronary intervention , 2019, Cardiovascular Diabetology.

[12]  Jingang Yang,et al.  The association between body mass index and in-hospital outcome among patients with acute myocardial infarction-Insights from China Acute Myocardial Infarction (CAMI) registry. , 2019, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[13]  Zhaoqing Sun,et al.  Temporal relationship between body mass index and triglyceride-glucose index and its impact on the incident of hypertension. , 2019, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[14]  G. Lip,et al.  2018 ESC/ESH Guidelines for the management of arterial hypertension. , 2018, European heart journal.

[15]  I. S. Kostina,et al.  Moderated Poster Session 3: Monday 4 May 2015, 10:00-11:00Room: Moderated Poster Area. , 2015, European heart journal cardiovascular Imaging.

[16]  A. Wierzbicki,et al.  Lipid modification and cardiovascular risk assessment for the primary and secondary prevention of cardiovascular disease: summary of updated NICE guidance , 2014, BMJ : British Medical Journal.

[17]  A. Ristic,et al.  Acute insulin resistance in ST-segment elevation myocardial infarction in non-diabetic patients is associated with incomplete myocardial reperfusion and impaired coronary microcirculatory function , 2014, Cardiovascular Diabetology.

[18]  A. Gnasso,et al.  Markers of insulin resistance and carotid atherosclerosis. A comparison of the homeostasis model assessment and triglyceride glucose index , 2013, International journal of clinical practice.

[19]  A. Chawla,et al.  Pleiotropic Actions of Insulin Resistance and Inflammation in Metabolic Homeostasis , 2013, Science.

[20]  G. Adler,et al.  The Renin Angiotensin Aldosterone System and Insulin Resistance in Humans , 2013, Current Hypertension Reports.

[21]  J. Sowers,et al.  Insulin resistance and heart failure: molecular mechanisms. , 2012, Heart failure clinics.

[22]  A. Jaffe,et al.  Why all the struggle about CK-MB and PCI? , 2012, European heart journal.

[23]  M. Saad,et al.  TyG index performs better than HOMA in a Brazilian population: a hyperglycemic clamp validated study. , 2011, Diabetes research and clinical practice.

[24]  M. Rodríguez-Moran,et al.  The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. , 2010, The Journal of clinical endocrinology and metabolism.

[25]  R. A. Rascón-Pacheco,et al.  Prediabetes and its relationship with obesity in Mexican adults: The Mexican Diabetes Prevention (MexDiab) Study. , 2008, Metabolic syndrome and related disorders.

[26]  J. Sowers,et al.  Renin-angiotensin-aldosterone system and oxidative stress in cardiovascular insulin resistance. , 2007, American journal of physiology. Heart and circulatory physiology.

[27]  G. Eknoyan,et al.  Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). , 2005, Kidney international.

[28]  Kamyar Kalantar-Zadeh,et al.  Reverse epidemiology of conventional cardiovascular risk factors in patients with chronic heart failure. , 2004, Journal of the American College of Cardiology.