Impacts of triglyceride-glucose index on prognosis of patients with type 2 diabetes mellitus and non-ST-segment elevation acute coronary syndrome: results from an observational cohort study in China

Abstract

Background: The relationship between triglyceride-glucose index (TyG index) and the prevalence and prognosis of cardiovascular disease has been confirmed by former studies. However, it remains uncertain whether TyG index has a prognostic impact in patients with type 2 diabetes mellitus (T2DM) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing percutaneous coronary intervention (PCI). Methods: The study retrospectively enrolled 798 patients (mean age: 60.9 ± 8.3 years; 68.3% men) with T2DM and NSTE-ACS who underwent PCI at Beijing Anzhen Hospital from January to December 2015. TyG index was calculated as previously reported: ln [fasting TGs (mg/dL) * FBG (mg/dL)/2]. The primary endpoint was a composite of adverse events as follows: all-cause death, non-fatal myocardial infarction (MI) and ischemia-driven revascularization. Results: TyG index was significantly higher in patients with a primary endpoint event compared with those without. Multivariate Cox proportional hazards analysis showed that 1-unit increase of TyG index was independently associated with higher risk of primary endpoint, independent of other risk factors [hazard ratio (HR) 3.208 per 1-unit increase, 95% confidence interval (CI) 2.400-4.289, P < 0.001]. The addition of TyG index to a baseline risk model had an incremental effect on the predictive value for adverse prognosis [AUC: baseline risk model, 0.800 vs. baseline risk model + TyG index, 0.856, P for comparison < 0.001; category-free net reclassification improvement (NRI) 0.346, P < 0.001; integrated discrimination improvement (IDI) 0.087, P < 0.001]. Conclusions: Increased TyG index is a significant predictor of adverse prognosis in patients with T2DM and NSTE-ACS undergoing PCI. Further studies need to be performed to determine whether interventions for TyG index have a positive impact on improving clinical prognosis.

Predictive Effect of Triglyceride‑Glucose Index on Clinical Events In Patients With Type 2 Diabetes Mellitus and Acute Myocardial Infarction: Results From an Observational Cohort Study In China

“…708, p < 0.001]. A similar statistical analysis was performed by Zhao et al, whose AUC value [AUC: covariates, 0.800 vs. covariates + TyG index, 0.856, p < 0.001] was higher than that of our study [25] . We think it may be related to the differences in sample size(798 patients vs. 1932 patients), study subjects(T 2 DM patients with NSTE-ACS who underwent PCI vs. T 2 DM patients with AMI), and endpoint events[(a composite of all-cause death, non-fatal MI and ischemia-driven revascularization) vs. (a composite of all-cause death, non-fatal MI, non-fatal stroke, cardiac rehospitalization, and revascularization)].…”

“…A study by Ma et al of 776 patients with T 2 DM and ACS who underwent PCI also showed that the TyG index was signi cantly associated with adverse CV outcomes, including all-cause mortality, non-fatal stroke, nonfatal MI and unplanned repeat revascularization [23] . In addition, a study including 798 patients with T 2 DM and NSTE-ACS undergoing PCI reported that 1-unit increase of TyG index was independently associated with higher risk of primary endpoint (a composite of all-cause death, non-fatal MI and ischemia-driven revascularization)[HR: 3.208 per 1-unit increase, 95% Cl: 2.40-4.29, p < 0.001], and the addition of TyG index to a baseline risk model had an incremental effect on the predictive value for adverse prognosis [AUC: baseline risk model, 0.800 vs. baseline risk model + TyG index, 0.856, p < 0.001] [25] . However, the predictive effects of the TyG index on MACCEs in patients with AMI combined with T 2 DM, are still unclear.…”

“…The TyG index was regarded as a reproducible, reliable, and valid surrogate marker of IR [12,14,15] . Numerous studies have indicated that the TyG index was signi cantly correlated with the occurrence of CVDs and poor CV prognosis [16][17][18][19][20][21][22][23][24][25] . However, no previous study has exclusively investigated the predictive value of the TyG index for adverse CVEs in AMI patients with T 2 DM.…”

Prognostic value of ST2 for MACEs and all-cause mortality in patients with coronary artery disease during a long-term follow up

“…Biomarkers have become increasingly important tools helping to improve patient outcome prognosis over the past two decades [20][21][22]. Numerous biomarkers have been identi ed in the diagnosis, prognosis and risk prediction of cardiovascular disease but few have made their way to clinical practice [23].…”

Prognostic value of suppression of tumorigenesis-2 (ST2) for cardiovascular events in coronary artery disease patients with and without diabetes mellitus

“…Over the past two decades, biomarkers have become increasingly important tools that help to improve patient outcome prognosis [22][23][24]. Numerous biomarkers have been identi ed in the diagnosis, prognosis and risk prediction of cardiovascular disease, but few have made their way to clinical practice [25].…”