Triglyceride−glucose index in the prediction of major adverse cardiovascular events in patients with type 2 diabetes mellitus after coronary artery bypass surgery: A retrospective cohort study

Abstract

BackgroundInsulin resistance (IR) is a significant risk factor for cardiometabolic diseases and a defining feature of type 2 diabetes mellitus (T2DM). This study aimed to examine the potential value of triglyceride-glucose (TyG) index as a predictor of prognosis in coronary heart disease (CHD) patients with T2DM after coronary artery bypass grafting (CABG) surgery and to facilitate the identification of those at high risk of major adverse cardiovascular events (MACEs) for closer monitoring or possible early intervention.MethodsThis study enrolled 386 T2DM patients who underwent CABG surgery at Nanjing Drum Tower Hospital. Patients were separated into two groups according to the median preoperative TyG Index. The Kaplan-Meier plot was used to compare the rate of MACEs-free survival in T2DM patients after CABG. The independent risk factors for the occurrence of MACEs were investigated using multivariate analysis. Nomogram was used to depict the predictive model.ResultsSignificantly more MACEs occurred in individuals with higher medians of the TyG index (65 (33.7%) vs. 39 (20.2%), p=0.003). TyG index [hazard ratio (HR) 12.926], LVEF [hazard ratio (HR) 0.916], and NYHA functional class III/IV [hazard ratio (HR) 4.331] were identified as independent predictors of MACEs incidence in post-CABG T2DM patients by multivariate analysis. The area under the curve (AUC) for predicting MACEs using the TyG index was 0.89 at five years. Combining the TyG index, LVEF, and NYHA functional class III/IV to build a novel risk assessment model for postoperative MACEs, the AUC climbed to 0.93 at five years. With AUCs, the nomogram comprised of the TyG index, LVEF, and NYHA functional class III/IV demonstrated strong specificity in the training and test sets.ConclusionsThe incidence of MACEs is high among post-CABG T2DM patients with a high TyG index. TyG index improves the diagnostic accuracy of MACEs, especially at long-term follow-up. A high TyG index may serve as an early warning signal for individuals to undertake lifestyle adjustments that can reduce the progression or incidence of MACEs.

The synergistic effect of the triglyceride-glucose index and serum uric acid on the prediction of major adverse cardiovascular events after coronary artery bypass grafting: a multicenter retrospective cohort study

“…In this regard, the TyG index exhibited great potential as a cardiovascular risk predictor [ 15 – 17 , 37 , 38 ]. In the present study, we confirmed again that the TyG index was independently associated with MACE in patients who underwent CABG, consistent with previous findings in patients with DM [ 18 , 39 ].…”

Combination of the triglyceride‐glucose index and EuroSCORE II improves the prediction of long‐term adverse outcomes in patients undergoing coronary artery bypass grafting

“…[32][33][34] The TyG index is a useful prognostic factor for adverse cardiovascular outcomes. 21,35,36 Consistent with previous studies, 22,23 our data showed that the TyG index was an independent risk factor for MACE in patients undergoing CABG. Given that no significant interaction was observed, a novel finding from our study is that the association of the TyG index and EuroSCORE II with MACE is independent of each other.…”

“…Notably, the relationships between the TyG index and various cardiovascular risk factors have been confirmed, 15–18 and previous studies have highlighted the TyG index as an independent risk factor for adverse cardiovascular outcomes 19–21 . Furthermore, two recent studies conducted in patients with diabetes mellitus (DM) showed that the TyG index might predict a worse prognosis after CABG 22,23 . However, few studies have investigated the combined association of the TyG index and EuroSCORE II with adverse outcomes in patients undergoing CABG.…”

“…[19][20][21] Furthermore, two recent studies conducted in patients with diabetes mellitus (DM) showed that the TyG index might predict a worse prognosis after CABG. 22,23 However, few studies have investigated the combined association of the TyG index and Euro-SCORE II with adverse outcomes in patients undergoing CABG.…”

Machine learning approach identifies miRNA signatures for breast cancer detection and classification from patient urine samples

“…This, to our knowledge, has not been shown before and raises the question of whether previous data should be reanalyzed with a more unbiased approach to possibly identify yet unknown patterns. However, only a machine learning approach can unravel this issue, as has been shown in other elds of research (22)(23)(24).…”