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

Abstract

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.

Non-insulin-based insulin resistance indexes in predicting atrial fibrillation recurrence following ablation: a retrospective study

“…Recently, METS-IR and TyG-BMI have been recognized as a more reliable indicators for assessing IR [ 33 , 37 ]. In our study, METS-IR and TyG-BMI index had a larger AUC area for AF recurrence after ablation, compared to traditional risk factor BMI and AF type, although LA diameter had a larger AUC area than METS-IR and TyG-BMI index.…”

Triglyceride–glucose index and serum uric acid on the prediction of major adverse cardiovascular and cerebrovascular events after PCI: a retrospective cohort study

“…Xie et al included 959 patients with CAD and end-stage renal disease, showed that The probability of MACE is the highest in patients with TyG index ＞9.4 mmol/L, compared to the lowest group of TyG index ≤8.77 mmol/L . Adding TyG index to the traditional model have promoted the predictive value of forecasting MACE [24]. And for patients with severe ischemic stroke, TyG index and in-hospital mortality were positively correlated [25].…”

The relationship between triglyceride-glucose index and prospective key clinical outcomes in patients hospitalised for coronary artery disease

“…Among CVD patients, an elevated TyG index has been associated with an increased risk of major adverse cardiovascular and cerebrovascular events in individuals with stable CHD combined with T2DM [ 16 ]. Numerous studies have independently confirmed the association of the TyG index with MACEs in patients with ACS, irrespective of T2DM status [ 17 – 23 ]. In our study, we also noted that an elevated TyG index beyond 8.77 and 8.62 was significantly associated with increased risks of both all-cause mortality and MACEs.…”

“…In the past decade, numerous studies have been conducted to ascertain if the TyG index can act as an alternative indicator of IR in stratifying the risk for adverse outcomes. The TyG index is not only associated with the occurrence of cardiovascular disease (CVD) [7][8][9][10][11][12][13][14][15] but also with adverse outcomes in patients with CVD [16][17][18][19][20][21][22][23]. Numerous studies have independently confirmed the association of the TyG index with adverse outcomes in CHD patients, both with and without T2DM [18,24,25].…”