Association of triglyceride-glucose index trajectories with the risk of worsening heart failure in elderly patients with chronic heart failure and type 2 diabetes: a competing risk analysis

BackgroundThe triglyceride-glucose index serves as a dependable biomarker for gauging insulin resistance linked to cardiovascular disease. Our study was designed to investigate how the trajectory of the triglyceride-glucose index relates to the risk of worsening heart failure and overall mortality in patients aged 60 years and older with chronic heart failure and type 2 diabetes.MethodsThis study enrolled 466 patients who had >= 3 medical exams. The formula for calculating the triglyceride-glucose index was ln (fasting triglycerides [mg/dL] x fasting blood glucose [mg/dL]/2). The trajectory of the triglyceride-glucose index in longitudinal analysis was analyzed via linear mixed models. The relationships between the trajectory of the TyG index and the risk of worsening heart failure and overall mortality were analyzed via competing Cox regression analysis and mixed-effects Cox regression analysis.ResultsAfter the variables adjustment, compared with the first quartile group, the adjusted hazard ratios for worsening heart failure in top quartile group were 2.40 (1.35-3.28) for 10-year follow-up, and 2.09 (1.22-3.58) for overall follow-up duration. The adjusted hazard ratios for overall mortality in top quartile group were 1.99 (1.56-3.14) for 10-year follow-up, and 1.87 (1.22-2.88) for overall follow-up duration. Compared with the low decreasing trajectory, adjusted hazard ratios for worsening heart failure of high decreasing trajectory were 1.37 (1.10-1.71) for the 5-year follow-up, 1.78 (1.10-2.88) for 10-year follow-up, and 1.67 (1.04-2.68) for overall follow-up duration. The adjusted hazard ratios for overall mortality were 2.16 (1.39-3.35) for 10-year follow-up, and 2.23 (1.46-3.40) for overall follow-up duration.ConclusionDuring follow-up, a higher baseline level of TyG index and a high decreasing trajectory were independently associated with long-term worsening heart failure and an increased risk of overall mortality.