Triglyceride-glucose index (TyG index) is a reliable surrogate marker of insulin resistance, associated with morbidity and prognosis of cardiovascular disease. However, its predictive value for cardiovascular events in patients with type 2 diabetes mellitus (T2DM) and chronic total occlusion (CTO) after percutaneous coronary intervention (PCI) has not been studied. Here, we retrospectively enrolled 681 patients with T2DM and CTO after PCI. Patients were divided into two groups based on a median TyG index of 9.02. The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The primary observational end point was the composite of overall death, nonfatal myocardial infarction, and unplanned revascularization. The Multivariate Cox hazards regression analysis showed that the TyG index was significantly correlated with the primary end point (hazard ratio = 1.699, 95% confidence interval 1.254–2.303, p = 0.001). The addition of TyG to a baseline risk model had an incremental effect on the predictive value for the primary end point (area under the curve: TyG index vs baseline model, 0.693 vs 0.663, comparison p = 0.040; integrated discrimination improvement = 0.049, p = 0.020). The TyG index might be a predictor of adverse cardiovascular events. Moreover, adding the TyG index into a baseline risk model had a cumulative effect on the predictive potential for the primary end point.
Background Retrograde approach technique has been challenging in percutaneous coronary interventional treatment of chronic total occlusion (CTO) coronary disease. The present study endeavors to determine a novel Chinese scoring system for predicting successful collateral channels traverse via retrograde approach. Methods The demographic characteristics and angiographic characteristics of 309 CTO patient were analyzed by univariable and multivariable analysis for selecting potential predictors. And the nomogram was used to establish the scoring system. Then it was evaluated by the internal and external validation. Results The predictors of Age, Connections between collateral channels and recipient vessels, and Channel Tortuosity (ACT) were identified with univariable and multivariable analysis and employed to the ACT score system. With acceptable calibrations, the area under curve of the scoring system and the external validation were 0.826 and 0.816 respectively. Based on score, the predictors were divided into three risk categories and it showed a consistent prediction power in the validation cohort. Conclusions The novel Chinese ACT score is a reliable tool for predicting successful retrograde collateral traverse.
Background: Glycated albumin (GA) is a useful glycaemic index that reflects short-term blood glucose control. Previous studies have been confirmed the predicted value of GA in atherosclerotic cardiovascular disease (ASCVD). However, The relationship between GA and the development of in-stent restenosis (ISR) after drug-eluting stent (DES) implantation has not been verified in patients with the acute coronary syndrome (ACS).Method: A total of 797 patients diagnosed with ACS who underwent re-coronary angiography more than six months after the first successful DES-based percutaneous coronary intervention (PCI) were eventually included in this study. Patients were categorized into two groups based on the median GA levels of 14.94%. Moreover, multivariate logistic regression analysis models, the net reclassification improvement (NRI) and integrated differentiation improvement (IDI) risk models were also constructed to assess the relationship between the GA and DES-ISR with ACS patients.Results: A total of 202 ( 25.3%) patients had DES-ISR during the follow-up period. The GA was significantly association with an increased risk of DES-ISR, Upon adjusting for confounding factors (As nominal variate: OR 1.868, 95% CI 1.191–2.932, P = 0.007; As continuous variate: OR 1.109, 95% CI 1.040–1.183, P =0.002). The addition of GA to a baseline risk model and an incremental effect on the predictive value for DES-ISR (AUC: GA vs. Baseline model, 0.714 vs. 0.692, comparison P = 0.017; Category-free net reclassification improvement (NRI) 0.080, P = 0.035; integrated discrimination improvement (IDI) 0.023, P < 0.001).Conclusion: GA level was significantly associated with a high risk of DES-ISR in patients with ACS treated with PCI. Moreover, the addition of the GA to a baseline risk model has an incremental effect on the predictive potential for DES-ISR.
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