Background: The triglyceride-glucose index (TyG index) has been regarded as a reliable alternative marker of insulin resistance and an independent predictor of cardiovascular outcomes. Whether the TyG index predicts adverse cardiovascular events in patients with diabetes and acute coronary syndrome (ACS) remains uncertain. The aim of this study was to investigate the prognostic value of the TyG index in patients with diabetes and ACS. Methods: A total of 2531 consecutive patients with diabetes who underwent coronary angiography for ACS were enrolled in this study. Patients were divided into tertiles according to their TyG index. The primary outcomes included the occurrence of major adverse cardiovascular events (MACEs), defined as all-cause death, non-fatal myocardial infarction and non-fatal stroke. The TyG index was calculated as the ln (fasting triglyceride level [mg/dL] × fasting glucose level [mg/dL]/2). Results: The incidence of MACE increased with TyG index tertiles at a 3-year follow-up. The Kaplan-Meier curves showed significant differences in event-free survival rates among TyG index tertiles (P = 0.005). Multivariate Cox hazards regression analysis revealed that the TyG index was an independent predictor of MACE (95% CI 1.201-1.746; P < 0.001). The optimal TyG index cutoff for predicting MACE was 9.323 (sensitivity 46.0%; specificity 63.6%; area under the curve 0.560; P = 0.001). Furthermore, adding the TyG index to the prognostic model for MACE improved the C-statistic value (P = 0.010), the integrated discrimination improvement value (P = 0.001) and the net reclassification improvement value (P = 0.019). Conclusions: The TyG index predicts future MACE in patients with diabetes and ACS independently of known cardiovascular risk factors, suggesting that the TyG index may be a useful marker for risk stratification and prognosis in patients with diabetes and ACS.

Background: Triglyceride-glucose index (TyG index) has been regarded as a reliable alternative marker of insulin resistance and an independent predictor of cardiovascular outcomes. Whether TyG index predicts adverse cardiovascular events in patients with diabetes and acute coronary syndrome (ACS) remains uncertain. The aim of the present study was to investigate the prognostic value of TyG index in patients with diabetes and ACS.Methods: A total of 2531 consecutive patients with diabetes who underwent coronary angiography for ACS were enrolled in the study. Patients were divided into 3 tertiles according to TyG index. The primary outcomes included the occurrence of major adverse cardiovascular events (MACE), defined as all-cause death, non-fatal myocardial infarction and non-fatal stroke. The TyG index was calculated as ln (fasting triglyceride level (mg/dL) ×fasting glucose level (mg/dL)/2).Results: The incidence of MACE increased with TyG index tertiles after 3-year follow-up. Kaplan-Meier curves showed significant differences in event-free survival rates among TyG index tertiles (P=0.005).Multivariate Cox hazards regression analysis revealed that TyG index was an independent predictor of MACE (95% CI 1.201-1.746; P<0.001). The optimal TyG index cut-off for predicting MACE was 9.323 (sensitivity 46.0% ; specificity 63.6%; area under the curve 0.560; P=0.001 ).Furthermore, adding TyG index to the prognostic model for MACE improved the C-statistic value (P=0.010), the integrated discrimination improvement value(P=0.001) and the net reclassification improvement value(P=0.019).Conclusions TyG index predicts future recurrent cardiovascular events in patients with diabetes and ACS, independently of known cardiovascular risk factors suggesting that TyG index may be a useful marker for risk stratification and prognosis in patients with diabetes and ACS.

Background and Aims: Studies have highlighted the role of the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio on subsequent cardiovascular events. However, the association of the TG/HDL-C ratio with survival outcomes in diabetic patients with coronary artery disease (CAD) treated with statins remains unknown. This study aimed to assess the predictive value of the TG/HDL-C ratio for all-cause mortality and cardiovascular death in diabetic patients with CAD treated with statins.Methods: The data of patients with type 2 diabetes and angiographically-confirmed CAD who were undergoing statin therapy and visited Tianjin Chest Hospital between January 2016 and September 2016 were retrospectively collected. The patients were categorized based on the baseline TG/HDL-C ratio tertile. Kaplan-Meier analysis and multivariate Cox proportional hazard regression were applied to assess the role of the TG/HDL-C ratio in predicting all-cause mortality and cardiovascular death.Results: A total of 2,080 patients were included. During the 4-year follow-up, 209 patients died, 136 of whom from cardiovascular death. The Kaplan-Meier analyses showed that an increased TG/HDL-C ratio was associated with an increased risk of all-cause mortality (P &lt; 0.001) and cardiovascular death (P &lt; 0.001). The multivariate cox hazard regression analysis revealed a similar effect of the TG/HDL-C ratio on the risk of all-cause mortality (P = 0.046) and cardiovascular death (P = 0.009). The role of the TG/HDL-C ratio in predicting all-cause mortality and cardiovascular death was similar among all subgroups (P &gt; 0.050). For all-cause mortality, the TG/HDL-C ratio significantly improved the C-statistic from 0.799 to 0.812 (P = 0.018), and the net reclassification index (NRI) and integrated discrimination index (IDI) were 0.252 (95% CI: 0.112–0.392; P &lt; 0.001) and 0.012 (95% CI: 0.003–0.022; P = 0.012), respectively. Similarly, for cardiovascular death, the TG/HDL-C ratio significantly improved the C-statistic from 0.771 to 0.804 (P &lt; 0.001), and the NRI and IDI were 0.508 (95% CI: 0.335–0.680; P &lt; 0.001) and 0.033 (95% CI: 0.015–0.050; P &lt; 0.001).Conclusion: TG/HDL-C ratio might be useful for predicting all-cause mortality and cardiovascular death in diabetic patients with CAD treated with statins.

We conducted a longitudinal study (from February 2017 to July 2017) to explore whether the triglyceride glucose index (TyG) index has a prognostic value for major adverse cardiovascular events (MACE) among high-risk Chinese hypertensives. The study population were from 6 districts of Tianjin, China. Finally, a total of 2250 patients were enrolled in this 3.5 year cohort study. The patients were divided into two groups according to the cut-off value of the TyG index: Low-TyG group (n = 901, TyG ≤ 8.87), High-TyG group (n = 1349, TyG > 8.87). Univariate and multivariate Cox regression analyses were used to estimate the relationship between the TyG and MACE. In multivariate cox regression analyses, the hazard ratio (HR) (95% confidence interval (CI)) of the high-TyG group was 1.313 (1.010, 1.708) compared with the low-TyG group. In those with an age ≤65 years and male subgroups, the prediction value of TyG was higher, and the risk of occurrence of MACE greater after adjusting other risk factors. The TyG index is an indicator to predict the development of MACE in hypertensive patients.

Objective This study aims to investigate the correlation between triglyceride–glucose index (TyG) and the risk of cardiovascular disease (CVD). Methods A total of 102,061 permanent residents of Tianjin, China, aged 35–75 years were surveyed. A questionnaire, physical examination, and blood tests for biochemical markers were conducted for all subjects. The risk of CVD was judged based on the results, identifying the population with a high risk of CVD. TyG was calculated for all subjects who were then grouped into TyG quartiles. The correlation between TyG and the detection rate of subjects with a high risk of CVD was analyzed using the chi-square test and Pearson’s correlation analysis. The cut-off points and the magnitude of the predictive effect of TyG in determining a high risk of CVD were identified by calculating the TyG through analysis of the receiver operator characteristic (ROC) curve. Results The surveyed population consisted of 39,598 males (38.8%) and 62,463 females (61.2%). The average age was 55.84 ± 10.27 years. A statistically significant difference in the incidence of a high CVD risk between subjects in the four groups divided by the TyG levels was identified ( p < 0.01). Pearson’s correlation analysis showed that TyG was correlated with all risk factors for CVD ( p < 0.01). The maximum Youden’s J statistic for determining the high risk of CVD was found at a TyG of 9.04 (specificity 0.575, sensitivity 0.754). The area under the ROC curve was 0.780 (confidence interval [CI]: 0.777, 0.783, p < 0.01). Conclusion TyG index is closely related to the aggregation of cardiovascular risk factors and is correlated with the judgment results of the screening population’s high risk of CVD, suggesting that more attention should be paid to the identification and control of multiple risk factors in the population with significantly elevated TyG.