Association between the triglyceride glucose index and in-hospital and 1-year mortality in patients with chronic kidney disease and coronary artery disease in the intensive care unit

Ye, Zixiang; An, Shuoyan; Gao, Yanxiang; Xie, Enmin; Zhao, Xianxian; Guo, Ziyu; Li, Yike; Shen, Nan; Zheng, Jingang

doi:10.1186/s12933-023-01843-2

Cited by 28 publications

(11 citation statements)

References 25 publications

(27 reference statements)

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“…By employing RCS analysis, we noticed a pattern of response to varying doses. The findings of this study partially coincide with prior research, providing further evidence of the correlation between the TyG index and unfavorable prognostic outcomes in different clinical presentations of CAD [ 24 – 26 ]. Of note, the observed significant difference between the TyG index tertiles for MACE appeared to be primarily driven by an increase in all-cause mortality rather than other secondary outcomes.…”

Section: Discussionsupporting

confidence: 89%

“…Likewise, a nested case–control investigation that concentrated on individuals with stable CAD revealed a favorable association between the TyG indicator and subsequent occurrences of cardiovascular events [ 25 ]. Furthermore, a research study including 639 individuals suffering from chronic kidney disease and CAD discovered that the TyG index can serve as a prognostic indicator for mortality within one year and during hospitalization [ 26 ]. Nevertheless, prior studies often overlooked or did not adequately include patients with ESRD, resulting in insufficient exploration of the prognostic potential of the TyG index in patients with both ESRD and CAD.…”

Section: Discussionmentioning

confidence: 99%

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The triglyceride-glucose index predicts 1-year major adverse cardiovascular events in end-stage renal disease patients with coronary artery disease

Xie,

Ye,

et al. 2023

Cardiovasc Diabetol

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Background The triglyceride-glucose (TyG) index has been suggested as a dependable indicator for predicting major adverse cardiovascular events (MACE) in individuals with cardiovascular conditions. Nevertheless, there is insufficient data on the predictive significance of the TyG index in end-stage renal disease (ESRD) patients with coronary artery disease (CAD). Methods This study, conducted at multiple centers in China, included 959 patients diagnosed with dialysis and CAD from January 2015 to June 2021. Based on the TyG index, the participants were categorized into three distinct groups. The study’s primary endpoint was the combination of MACE occurring within one year of follow-up, including death from any cause, non-fatal myocardial infarction, and non-fatal stroke. We assessed the association between the TyG index and MACE using Cox proportional hazard models and restricted cubic spline analysis. The TyG index value was evaluated for prediction incrementally using C-statistics, continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results The three groups showed notable variations in the risk of MACE (16.3% in tertile 1, 23.5% in tertile 2, and 27.2% in tertile 3; log-rank P = 0.003). Following complete adjustment, patients with the highest TyG index exhibited a notably elevated risk of MACE in comparison to those in the lowest tertile (hazard ratio [HR] 1.63, 95% confidence interval [CI] 1.14–2.35, P = 0.007). Likewise, each unit increase in the TyG index correlated with a 1.37-fold higher risk of MACE (HR 1.37, 95% CI 1.13–1.66, P = 0.001). Restricted cubic spline analysis revealed a connection between the TyG index and MACE (P for nonlinearity > 0.05). Furthermore, incorporating the TyG index to the Global Registry of Acute Coronary Events risk score or baseline risk model with fully adjusted factors considerably enhanced the forecast of MACE, as demonstrated by the C-statistic, continuous NRI, and IDI. Conclusions The TyG index might serve as a valuable and dependable indicator of MACE risk in individuals with dialysis and CAD, indicating its potential significance in enhancing risk categorization in clinical settings.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

The triglyceride-glucose index predicts 1-year major adverse cardiovascular events in end-stage renal disease patients with coronary artery disease

Xie,

Ye,

et al. 2023

Cardiovasc Diabetol

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“… 6 As an alternative to the conventional gold standard hyperinsulinemic‐euglycemic clamp method, the TyG index was introduced as a more simple and cost‐effective means of IR with high sensitivity (96.5%) and specificity (85%). 14 Currently, the TyG index has been extensively explored in diverse medical issues, such as cardiovascular disease, 6 , 7 , 8 , 9 arterial stiffness progression, 10 diabetic nephropathy, 11 new‐onset hypertension, 15 cardiometabolic diseases, 16 DM, 17 , 18 , 19 intensity care unit mortality, 20 obesity, 21 and hearing impairment. 22 However, there are relative few reports about TyG index and hypertensive nephropathy.…”

Section: Discussionmentioning

confidence: 99%

Triglyceride glucose index and renal function decline in Han Chinese hypertensive patients

Chen,

Tsai,

Huang

2023

J of Clinical Hypertension

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Elevated triglyceride glucose (TyG) index is associated with an increased risk of cardiovascular disease. The current study aimed to investigate whether the TyG index was correlated with renal function decline in patients with hypertension. Han Chinese participants with essential hypertension were included. The TyG index was calculated as ln[fasting triglycerides (mg/dL) * fasting glucose (mg/dL)/2]. Renal function decline was defined as >25% decline in estimated glomerular filtration rate (eGFR). The Cox proportional hazard regression model was used to examine the independent effect of the TyG index on renal events. In total, 548 Han Chinese hypertensive participants with a mean age of 62.1 ± 14.3 years were eligible for enrollment. During a mean follow‐up period of 4.7 ± 3.1 years, 97 patients suffered from >25% decline in eGFR. When compared to those without eGFR decline, patients with eGFR decline had higher fasting triglyceride levels (P = .056), fasting glucose levels (P = .014), and TyG indexes (P = .014). The Cox proportional hazard regression model revealed that the TyG index (hazard ratio [HR] = 1.490; 95% confidence interval [CI] = 1.016–2.185, P = .041), office systolic blood pressure (HR = 1.013; 95% CI = 1.000–1.026, P = .047), diabetes mellitus (HR = 1.797, 95% CI = 1.026–3.147, P = .040), and baseline eGFR (HR = 1.015; 95% CI = 1.002–1.028, P = .025) were associated with renal events. In conclusions, an elevated TyG index is independently associated with an increased risk of eGFR decline in hypertensive patients.

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“…The research included individuals who were diagnosed with both CAD and CKD using ICD-9 and ICD-10 codes from the website https://www.icd.who.int/browse10/2019/en . CAD was defined according to the codes 410–411 (ICD-9) and I20–I21 (ICD-10), and CKD was defined based on the codes 585, V451 (ICD-9) and N18, Z99.2 (ICD-10) [ 15 ]. Individuals who had less than 6 h of ICU stay were under the age of 18, lacked baseline creatinine readings, or had over 30% missing data, or the absence of lymphocyte and neutrophil values, were excluded.…”

Section: Methodsmentioning

confidence: 99%

Association between the neutrophil-to-lymphocyte ratio and in-hospital mortality in patients with chronic kidney disease and coronary artery disease in the intensive care unit

Luo,

Zhou,

Song

et al. 2024

Eur J Med Res

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Background The objective of this study was to investigate the correlation between neutrophil-to-lymphocyte ratios (NLR) and the risk of in-hospital death in patients admitted to the intensive care unit (ICU) with both chronic kidney disease (CKD) and coronary artery disease (CAD). Methods Data from the MIMIC-IV database, which includes a vast collection of more than 50,000 ICU admissions occurring between 2008 and 2019, was utilized in the study and eICU-CRD was conducted for external verification. The Boruta algorithm was employed for feature selection. Univariable and multivariable logistic regression analyses and multivariate restricted cubic spline regression were employed to scrutinize the association between NLR and in-hospital mortality. The receiver operating characteristic (ROC) curves were conducted to estimate the predictive ability of NLR. Results After carefully applying criteria to include and exclude participants, a total of 2254 patients with CKD and CAD were included in the research. The findings showed a median NLR of 7.3 (4.4, 12.1). The outcomes of multivariable logistic regression demonstrated that NLR significantly elevated the risk of in-hospital mortality (OR 2.122, 95% confidence interval [CI] 1.542–2.921, P < 0.001) after accounting for all relevant factors. Further insights from subgroup analyses unveiled that age and Sequential Organ Failure Assessment (SOFA) scores displayed an interactive effect in the correlation between NLR and in-hospital deaths. The NLR combined with traditional cardiovascular risk factors showed relatively great predictive value for in-hospital mortality (AUC 0.750). Conclusion The findings of this research indicate that the NLR can be used as an indicator for predicting the likelihood of death during a patient’s stay in the intensive care unit, particularly for individuals with both CAD and CKD. The results indicate that NLR may serve as a valuable tool for assessing and managing risks in this group at high risk. Further investigation is required to authenticate these findings and investigate the mechanisms that underlie the correlation between NLR and mortality in individuals with CAD and CKD.

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Association between the triglyceride glucose index and in-hospital and 1-year mortality in patients with chronic kidney disease and coronary artery disease in the intensive care unit

Cited by 28 publications

References 25 publications

The triglyceride-glucose index predicts 1-year major adverse cardiovascular events in end-stage renal disease patients with coronary artery disease

The triglyceride-glucose index predicts 1-year major adverse cardiovascular events in end-stage renal disease patients with coronary artery disease

Triglyceride glucose index and renal function decline in Han Chinese hypertensive patients

Association between the neutrophil-to-lymphocyte ratio and in-hospital mortality in patients with chronic kidney disease and coronary artery disease in the intensive care unit

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