Evaluation of the long-term prognostic ability of triglyceride-glucose index for elderly acute coronary syndrome patients: a cohort study

Abstract

Background With the advancement of the world population aging, more attention should be paid to the prognosis of elderly patients with acute coronary syndrome (ACS). Triglyceride-glucose (TyG) index is a reliable indicator of insulin resistance (IR) and is closely related to traditional risk factors of cardiovascular disease (CVD). However, the effect of TyG index on the prognosis of long-term adverse events in elderly ACS patients has not been reported. This study evaluated the prognostic power of TyG index in predicting adverse events in elderly ACS patients. Methods In this study, 662 ACS patients > 80 years old who were hospitalized from January 2006 to December 2012 were enrolled consecutively and the general clinical data and baseline blood biochemical indicators were collected. The follow-up time after discharge was 40–120 months (median, 63 months; interquartile range, 51‒74 months). In addition, the following formula was used to calculate the TyG index: Ln [fasting TG (mg/dL) × FBG (mg/dL)/2], and patients were divided into three groups according to the tertile of the TyG index. Results The mean age of the subjects was 81.87 ± 2.14 years, the proportion of females was 28.10%, and the mean TyG index was 8.76 ± 0.72. The TyG index was closely associated with the traditional risk factors of CVD. In the fully-adjusted Cox regression model, the Hazard ratio (95% CI) of all-cause mortality (in tertile 3) was 1.64 (1.06, 2.54) and major adverse cardiac event (MACE) (in tertile 3) was 1.36 (1.05, 1.95) for each SD increase in the TyG index. The subgroup analyses also confirmed the significant association of the TyG index and long-term prognosis. Conclusion The TyG index is an independent predictor of long-term all-cause mortality and MACE in elderly ACS patients.

Triglyceride-glucose index in the prediction of adverse cardiovascular events in patients with premature coronary artery disease: a retrospective cohort study

“…However, the hyperinsulinemic-euglycemic clamp technique is costly and time‐consuming [ 13 ], whereas HOMA-IR is likely to cause significant bias because of insulin measurements [ 30 , 31 ]. In this regard, the TyG index, as a simple surrogate for IR, has proven to be of prognostic value for CAD [ 21 , 22 ]. The prognostic value of the TyG index for patients with PCAD remains, however, poorly known.…”

“…Zhu Y et al retrospectively recruited patients who were admitted for acute coronary syndrome (ACS) and underwent PCI and found that the TyG index was associated with in-stent restenosis [ 21 ]. Jiao Y et al found that the TyG index was an independent predictor of all-cause mortality and MACE in a cohort study including 662 elderly patients with ACS [ 22 ]. The prognostic value of TyG in young patients was first discovered in this study.…”

“…Previous studies showed the addition of the TyG index to the baseline risk model could improve the MACE prediction in patients after PCI and elderly ACS patients [ 21 , 22 ]. In our study, we found that the addition of the TyG index has a significant incremental prognostic value for predicting MACE in patients with PCAD.…”

“…Tehran Lipid and Glucose Study (TLGS) reported that TyG was independently associated with incident CVD, especially among the younger age group (< 60 years) [ 20 ]. Recent studies also showed that the TyG index could predict the in-stent restenosis and prognosis of elderly acute coronary syndrome (ACS) patients [ 21 , 22 ]. However, little research has investigated the TyG index in patients with PCAD.…”

Triglyceride-glucose index linked to all-cause mortality in critically ill patients: a cohort of 3026 patients

“…Former studies have proved that TyG index has high correlation with hyperinsulinaemic–euglycaemic clamp, either in individuals with or without DM [ 16 , 25 ]. In addition, compared with the HOMA-IR, TyG index showed better evaluation efficiency [ 26 , 27 ]. Among them, serum triglyceride and glucose are low-cost routine biochemical detection items [ 6 ], therefore, the immense advantage of using such a simple method of IR identification is obviously that it is easily accessible in any clinical settings and has a good application prospect [ 28 ].…”