High Triglyceride-Glucose Index is Associated with Poor Cardiovascular Outcomes in Nondiabetic Patients with ACS with LDL-C below 1.8 mmol/L

Zhang, Yue; Ding, Xiaosong; Hua, Bing; Liu, Qingbo; Gao, Hui; Chen, Hui; Zhao, Xiaohui; Li, Weiping; Li, Hongwei

doi:10.5551/jat.61119

Cited by 35 publications

(25 citation statements)

References 37 publications

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Section: Sensitivity Analyses Meta-regression Analyses and Subgroup Analysesmentioning

confidence: 77%

“…In the sensitivity analysis of primary outcome, we found that removing each study did not remarkably reduce the heterogeneity except the study of Zhang et al (35) which slightly reduced the heterogeneity (I 2 = 66.1%, P = 0.003). It should be noted that the study of Zhang et al (35) differs from others in LDL-C below 1.8 mmol/L. Besides, sensitivity analysis of primary outcome revealed that the removal of any one study did not substantially alter the overall estimation of HR for MACEs.…”

Section: Sensitivity Analyses Meta-regression Analyses and Subgroup Analysesmentioning

confidence: 77%

“…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.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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

Luo

Duan

et al. 2021

Front. Cardiovasc. Med.

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Background: Insulin resistance (IR) represents a critical regulator in the development and progress of coronary artery disease (CAD). Triglyceride-glucose (TyG) index, a novel surrogate biomarker of IR, has been implicated in several cardiovascular diseases. Accordingly, we conduct a meta-analysis to elucidate the relationship between TyG index and adverse cardiovascular events in patients with CAD.Methods: To identify the studies examining the predictive capacity of the TyG index for adverse cardiovascular events in the setting of CAD, we performed a comprehensive literature retrieval of Scopus, PubMed, EMBASE, and Web of Science, from the inception of databases to October 5, 2021. We pooled the adjusted hazard ratio (HR) along with 95% CI using a random-effects model. The primary outcome was a composite of major adverse cardiovascular events (MACEs), including all-cause death, cardiovascular death (CV death), myocardial infarction (MI), stroke, hospitalization for unstable angina or heart failure, and revascularization. The secondary outcomes were all-cause death, CV death, MI, stroke, and revascularization. Additionally, we conducted subgroup analyses stratified by diabetes status, age, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), category of TyG index, sample size, follow-up duration, and study design.Results: About 12 studies involving 28,795 patients with CAD were finally taken into the quantitative analysis. Our findings showed that there was a 2.14-fold higher risk of MACEs among CAD populations in the highest TyG group compared with those in the lowest TyG group (HR: 2.14, 95% CI: 1.69–2.71, P < 0.001). A greater risk of MACEs was observed in participants with higher BMI than those with lower BMI (P = 0.03 for interaction). In the analysis of secondary outcomes, we also observed a markedly increased risk of MI, stroke, and revascularization in the highest TyG group compared with the lowest TyG group. No evidence of a significant association between TyG index and CV mortality or all-cause mortality in patients with CAD was identified.Conclusions: The elevated TyG index is a promising predictive factor of adverse cardiovascular events in patients with CAD.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42021228521.

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Section: Sensitivity Analyses Meta-regression Analyses and Subgroup Analysesmentioning

confidence: 77%

Section: Sensitivity Analyses Meta-regression Analyses and Subgroup Analysesmentioning

confidence: 77%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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

Luo

Duan

et al. 2021

Front. Cardiovasc. Med.

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“…Another recent cohort study in China conducted by Zhang et al included 1,655 nondiabetic ACS subjects whose LDL-C was below 1.8 mmol/L. The outcome suggested that the TyG index was closely related to the incidence of acute myocardial infarction, infarct size, and prevalence of revascularization (38). This may indicate that TyG, representing insulin resistance, is one of the predictors of residual cardiovascular and cerebrovascular risk in patients with well-controlled cholesterol levels when cholesterollowering treatment is the cornerstone of secondary prevention of CAD today.…”

Section: Discussionmentioning

confidence: 99%

The Impact of the Triglyceride-Glucose Index on Poor Prognosis in NonDiabetic Patients Undergoing Percutaneous Coronary Intervention

et al. 2021

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BackgroundThe triglyceride-glucose index (TyG index) is a valuable marker for predicting adverse cardiovascular events in diabetic patients. However, for nondiabetic patients, whether the TyG index is independently related to poor prognosis remains unclear. This cohort study assessed the association of the TyG index with future cardiovascular risk in nondiabetic subjects who received percutaneous coronary intervention (PCI).MethodsWe consecutively enrolled 5,489 nondiabetic patients who underwent PCI. All experimental subjects were divided into three groups based on their TyG index, which was determined by the equation ln (fasting triglyceride (mg/dl) × fasting blood glucose (mg/dl)/2). The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), including all-cause death, nonfatal myocardial infarction (MI), nonfatal stroke, and target vessel revascularization (TVR).ResultsA total of 386 MACCE were documented during a median 29-month follow-up. The Kaplan–Meier survival results indicated that among the three groups, there was no obvious difference in any endpoints. Further Cox regression analyses suggested that the TyG index was not independently related to adverse cardiovascular outcomes for nondiabetic patients who underwent PCI (HR: 0.77, 95% CI 0.56–1.16, P = 0.210 for MACCE). Subgroup analysis suggested that the TyG index was independently relevant to MACCE for patients with low-density lipoprotein cholesterol (LDL-C) lower than 1.8 mmol/L.ConclusionThe TyG index is not an effective predictive factor for adverse cardiovascular prognosis in nondiabetic patients who underwent PCI. However, in subjects with LDL-C lower than 1.8mmol/L, it may predict future cardiovascular risk.

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“…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].…”

Section: Discussionmentioning

confidence: 99%

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

Zeng

Zhou

Xue

et al. 2021

Preprint

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Background: Triglyceride-glucose (TyG) index and homeostasis model assessment-insulin resistance (HOMA-IR) are related to insulin resistance (IR). The aim of this study was to assess the association between triglyceride-glucose index / HOMA-IR within young adults and congestive heart failure (CHF), and to explore whether triglyceride-glucose index can replace HOMA-IR as a surrogate marker for insulin resistance in predicting the risk of CHF.Methods：A total of 4992 participants between the ages of 18 and 30 were enrolled from the Coronary Artery Risk Development in Young Adults (CARDIA) investigation (from 1985 to 1986 [year 0]). Cox proportional hazard regression analysis was conducted for assessing correlations between baseline TyG index / HOMA-IR and congestive heart failure events, together with Receiver Operating Characteristic (ROC) Curve employed for scrutinizing TyG index / HOMA-IR and he risk of CHF.Results: During the 31-year follow-up period, 64 (1.3%) out of the 4992 participants developed congestive heart failure. In multivariable Cox proportional hazards models, adjusted for confounding factors for CHF, increased risk of CHF was associated with per-unit increase in TyG index (hazard ratio [HR] 2.8; 95% confidence interval [CI], 1.7-4.7) and HOMA-IR (HR 1.2; 95%CI, 1.1-1.3). Kaplan-Meier curve analysis showed that participants in the TyG index and HOMA-IR index Q4 group had a higher risk of congestive heart failure than those in the Q1 group. The area under curve (AUC) for TyG index and HOMA-IR consisted of 0.67 (95% CI, 0.6-0.742) and 0.675 (95%CI, 0.604-0.746), respectively. There were no significant differences between TyG index and HOMA-IR for AUC (P = 0.986).Conclusions: TyG index and HOMA-IR are independent risk factors for CHF. The TyG index can replace HOMA-IR in young adulthood as a surrogate marker for IR to predict the risk of CHF.

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High Triglyceride-Glucose Index is Associated with Poor Cardiovascular Outcomes in Nondiabetic Patients with ACS with LDL-C below 1.8 mmol/L

Cited by 35 publications

References 37 publications

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

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

The Impact of the Triglyceride-Glucose Index on Poor Prognosis in NonDiabetic Patients Undergoing Percutaneous Coronary Intervention

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

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