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 Acute myocardial infarction (AMI) is the main cause of death and disability in cardiovascular and cerebrovascular diseases. Both the Global Registry of Acute Coronary Events (Grace) score and high‐sensitivity C‐reactive protein (hs‐CRP) were associated with prognosis in patients with AMI. However, whether the addition of the hs‐CRP to Grace risk score could improve the predictive power of Grace risk score on the prognosis of patients with AMI is unclear. Hypothesis: We hypothesized that the inclusion of hs‐CRP in the Grace risk score could improve the ability to correctly distinguish the occurrence of in‐hospital outcomes. Methods We retrospectively enrolled 1804 patients with AMI in the final analysis. Patients were divided into four groups by hs‐CRP quartiles. The relation between hs‐CRP and Grace risk score was analyzed by Spearman rank correlation. Logistic regression was used to identify independent risk factors. The predictive value of hs‐CRP add to Grace risk score was evaluated by C‐statistic, net reclassification improvement (NRI), integrated differentiation improvement (IDI), calibration plot, and decision curve analysis. Results The hs‐CRP and Grace risk score had a significantly positive correlation (r = .191, p < .001). hs‐CRP combined with Grace risk score could improve the ability of Grace risk score alone to correctly redistinguish the occurrence of in‐hospital outcome (C‐statistic = 0.819, p < .001; NRI = 0.05956, p = .007; IDI = 0.0757, p < .001). Conclusion Admission hs‐CRP level was a significant independent risk factor for in‐hospital outcomes in patients with AMI. The inclusion of hs‐CRP in the Grace risk score could improve the ability to correctly distinguish the occurrence of in‐hospital outcomes.
BackgroundPrevious studies have confirmed the predicted value of serum glycated albumin (GA) in atherosclerotic cardiovascular disease. 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 acute coronary syndrome (ACS).Materials and methodsIn this study, 797 patients diagnosed with ACS who underwent re-coronary angiography more than 6 months after the first successful DES-based percutaneous coronary intervention (PCI) were eventually included. Patients were categorized into two groups based on the median GA levels of 14.94%. Moreover, multivariate logistic regression analysis models and the net reclassification improvement and integrated differentiation improvement risk models were constructed to assess the relationship between the GA and DES-ISR in patients with ACS.ResultsThe GA was significantly associated 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 had 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).ConclusionGA 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.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.