Prognostic significance of triglyceride-glucose index in acute coronary syndrome patients without standard modifiable cardiovascular risk factors

被引:6
作者
Zhang, Xiaoming [1 ]
Du, Yu [1 ]
Zhang, Tianhao [1 ]
Zhao, Zehao [1 ]
Guo, Qianyun [1 ]
Ma, Xiaoteng [1 ]
Shi, Dongmei [1 ]
Zhou, Yujie [1 ]
机构
[1] Capital Med Univ, Beijing Inst Heart Lung & Blood Vessel Dis, Clin Ctr Coronary Heart Dis, Beijing Key Lab Precis Med Coronary Atherosclerot, Beijing 100029, Peoples R China
关键词
Triglyceride glucose index; Standard modifiable cardiovascular risk factors; Acute coronary syndrome; Prognosis; INSULIN-RESISTANCE; MYOCARDIAL-INFARCTION; ARTERY-DISEASE; ATHEROSCLEROSIS; ASSOCIATION; MORTALITY; OUTCOMES; REGISTRY; IMPACT;
D O I
10.1186/s12933-024-02345-5
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BackgroundA significant percentage of patients with acute coronary syndrome (ACS) without standard modifiable cardiovascular risk factors (SMuRFs) are being identified. Nonetheless, the prognostic influence of the TyG index on adverse events in this type of patient remains unexplored. The aim of this study was to assess the prognostic value of the TyG index among ACS patients without SMuRFs for predicting adverse outcomes. MethodsThis study involved 1140 consecutive patients who were diagnosed with ACS without SMuRFs at Beijing Anzhen Hospital between May 2018 and December 2020 and underwent coronary angiography. Each patient was followed up for a period of 35 to 66 months after discharge. The objective of this study was to examine major adverse cardiac and cerebrovascular events (MACCE), which included all-cause mortality, non-fatal myocardial infarction, non-fatal ischemic stroke, as well as ischemia-driven revascularization. ResultsDuring the median follow-up period of 48.3 months, 220 (19.3%) MACCE events occurred. The average age of the participants was 59.55 +/- 10.98 years, and the average TyG index was 8.67 +/- 0.53. In the fully adjusted model, when considering the TyG index as either a continuous/categorical variable, significant associations with adverse outcomes were observed. Specifically, for each 1 standard deviation increase in the TyG index within the highest TyG index group, there was a hazard ratio (HR) of 1.245 (95% confidence interval CI 1.030, 1.504) for MACCE and 1.303 (95% CI 1.026, 1.653) for ischemia-driven revascularization (both P < 0.05), when the TyG index was analyzed as a continuous variable. Similarly, when the TyG index was examined as a categorical variable, the HR (95% CI) for MACCE in the highest TyG index group was 1.693 (95% CI 1.051, 2.727) (P < 0.05) in the fully adjusted model, while the HR (95% CI) for ischemia-driven revascularization was 1.855 (95% CI 0.998, 3.449) (P = 0.051). Additionally, the TyG index was found to be associated with a poor prognosis among the subgroup. ConclusionThe TyG index is correlated with poor prognosis in patients with ACS without SMuRFs, suggesting that it may be an independent predictive factor of adverse events among these individuals.
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页数:13
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共 47 条
[1]   Insulin resistance is associated with subclinical vascular disease in humans [J].
Adeva-Andany, Maria M. ;
Ameneiros-Rodriguez, Eva ;
Fernandez-Fernandez, Carlos ;
Dominguez-Montero, Alberto ;
Funcasta-Calderon, Raquel .
WORLD JOURNAL OF DIABETES, 2019, 10 (02) :63-77
[2]   The association between triglyceride-glucose index and major adverse cardiovascular events in patients with acute coronary syndrome - dose-response meta-analysis [J].
Akbar, Mohammad R. ;
Pranata, Raymond ;
Wibowo, Arief ;
Irvan ;
Sihite, Teddy A. ;
Martha, Januar W. .
NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES, 2021, 31 (11) :3024-3030
[3]   Coronary artery disease in the absence of traditional risk factors: a call for action [J].
Avis, Suzanne R. ;
Vernon, Stephen T. ;
Hagstrom, Emil ;
Figtree, Gemma A. .
EUROPEAN HEART JOURNAL, 2021, 42 (37) :3822-3824
[4]   The Role of Oxidative Stress in Atherosclerosis [J].
Batty, Matthew ;
Bennett, Martin R. ;
Yu, Emma .
CELLS, 2022, 11 (23)
[5]   Lowering the Triglyceride/High-Density Lipoprotein Cholesterol and its Association With the Beneficial Impact of Pioglitazone on Coronary Atherosclerosis in the PERISCOPE Study Is Likely Due to Lowering Insulin Resistance [J].
Bell, David S. H. ;
O'Keefe, James H. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2011, 58 (07) :778-778
[6]   Atherosclerosis: Pathophysiology of insulin resistance, hyperglycemia, hyperlipidemia, and inflammation [J].
Beverly, Joshua K. ;
Budoff, Matthew J. .
JOURNAL OF DIABETES, 2020, 12 (02) :102-104
[7]   Insulin resistance, lipotoxicity, type 2 diabetes and atherosclerosis: the missing links. The Claude Bernard Lecture 2009 [J].
DeFronzo, R. A. .
DIABETOLOGIA, 2010, 53 (07) :1270-1287
[8]   Clinical Pathway for Coronary Atherosclerosis in Patients Without Conventional Modifiable Risk Factors JACC State-of-the-Art Review [J].
Figtree, Gemma A. ;
Vernon, Stephen T. ;
Harmer, Jason A. ;
Gray, Michael P. ;
Arnott, Clare ;
Bachour, Eric ;
Barsha, Giannie ;
Brieger, David ;
Brown, Alex ;
Celermajer, David S. ;
Channon, Keith M. ;
Chew, Nicholas W. S. ;
Chong, James J. H. ;
Chow, Clara K. ;
Cistulli, Peter A. ;
Ellinor, Patrick T. ;
Grieve, Stuart M. ;
Guzik, Tomasz J. ;
Hagstrom, Emil ;
Jenkins, Alicia ;
Jennings, Garry ;
Keech, Anthony C. ;
Kott, Katharine A. ;
Kritharides, Leonard ;
Mamas, Mamas A. ;
Mehran, Roxana ;
Meikle, Peter J. ;
Natarajan, Pradeep ;
Negishi, Kazuaki ;
O'Sullivan, John ;
Patel, Sanjay ;
Psaltis, Peter J. ;
Redfern, Julie ;
Steg, Philippe G. ;
Sullivan, David R. ;
Sundstrom, Johan ;
Vogel, Birgit ;
Wilson, Andrew ;
Wong, Dennis ;
Bhatt, Deepak L. ;
Kovacic, Jason C. ;
Nicholls, Stephen J. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2023, 82 (13) :1343-1359
[9]   Coronary artery disease patients without standardmodifiable risk factors (SMuRFs)- a forgotten group calling out for new discoveries [J].
Figtree, Gemma A. ;
Vernon, Stephen T. .
CARDIOVASCULAR RESEARCH, 2021, 117 (06) :E76-E78
[10]   Mortality in STEMI patients without standard modifiable risk factors: a sex-disaggregated analysis of SWEDEHEART registry data [J].
Figtree, Gemma A. ;
Vernon, Stephen T. ;
Hadziosmanovic, Nermin ;
Sundstrom, Johan ;
Alfredsson, Joakim ;
Arnott, Clare ;
Delatour, Vincent ;
Leosdottir, Margret ;
Hagstrom, Emil .
LANCET, 2021, 397 (10279) :1085-1094