Predictive effect of triglyceride‑glucose index on clinical events in patients with type 2 diabetes mellitus and acute myocardial infarction: results from an observational cohort study in China

Abstract

Background Triglyceride glucose (TyG) index is considered a reliable alternative marker of insulin resistance and an independent predictor of cardiovascular (CV) outcomes. However, the prognostic value of TyG index in patients with type 2 diabetes mellitus (T2DM) and acute myocardial infarction (AMI) remains unclear. Methods A total of 1932 consecutive patients with T2DM and AMI were enrolled in this study. Patients were divided into tertiles according to their TyG index levels. The incidence of major adverse cardiac and cerebral events (MACCEs) was recorded. The TyG index was calculated as the ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. Results Competing risk regression revealed that the TyG index was positively associated with CV death [2.71(1.92 to 3.83), p < 0.001], non-fatal MI [2.02(1.32 to 3.11), p = 0.001], cardiac rehospitalization [2.42(1.81 to 3.24), p < 0.001], revascularization [2.41(1.63 to 3.55), p < 0.001] and composite MACCEs [2.32(1.92 to 2.80), p < 0.001]. The area under ROC curve of the TyG index for predicting the occurrence of MACCEs was 0.604 [(0.578 to 0.630), p < 0.001], with the cut-off value of 9.30. The addition of TyG index to a baseline risk model had an incremental effect on the predictive value for MACCEs [net reclassification improvement (NRI): 0.190 (0.094 to 0.337); integrated discrimination improvement (IDI): 0.027 (0.013 to 0.041); C-index: 0.685 (0.663 to 0.707), all p < 0.001]. Conclusions The TyG index was significantly associated with MACCEs, suggesting that the TyG index may be a valid marker for risk stratification and prognosis in patients with T2DM and AMI. Trial registration Retrospectively registered.

Prognostic Significance of Triglyceride-Glucose Index for Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis

“…In this meta-analysis, five articles (30,(32)(33)(34)(35) reported the relationship between the TyG index with all-cause mortality in CAD populations, and our findings showed that the TyG index was not associated with all-cause death in CAD regardless of diabetes status. An analogous result was obtained in the study of Drwila et al (18) among non-diabetic patients with AMI.…”

“…Figure 1 shows the literature selection process. About 12 studies (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) with a total of 28,795 patients with CAD were finally included in the qualitative and quantitative analysis. All the included studies were published within the last 5 years and were situated in China.…”

MIKB: A manually curated and comprehensive knowledge base for myocardial infarction

“…Therefore, HIF-1 may be a potential therapeutic target for MI [56] . According to existing research, insulin resistance is considered to be an important mechanism for the pathogenesis of MI, which is related to atherosclerosis and cardiovascular risk [57] , [58] . Ellmers et al .…”

Triglyceride-Glucose Index and HOMA-IR in Young Adulthood and Risk of Incident Congestive Heart Failure: The CARDIA Study

“…The TyG index can also predict the risk of diabetes mellitus [39]. Many studies demonstrated that the TyG index is closely related to the prognosis of acute coronary syndrome [40][41][42]. Acute coronary syndrome, hypertension, diabetes mellitus and other factors can cause cardiac function and structural disorders, leading to heart failure [43].…”