Influence of age on the association between the triglyceride-glucose index and all-cause mortality in patients with cardiovascular diseases

Abstract

Background In patients with cardiovascular diseases, it is reported that the triglyceride-glucose index (TGI) potentially indicates prognosis. However, the results are controversial. Moreover, whether age has an impact on the predictive value of TGI remains unclear. Methods Participants with cardiovascular diseases were enrolled using the China Health and Retirement Longitudinal Study (CHARLS) registry. TGI was calculated as ln (triglyceride×glucose/2). The survival status was recorded every 2 years in the follow-up waves. Multivariate regression analysis was carried out to determine the relationship between TGI levels and long-term all-cause mortality in patients grouped by different age. Patients younger than 65 years old were regarded as middle-aged group. Otherwise, they were classified as old group. Results In total, 2923 patients with cardiovascular diseases and baseline blood test results were included. After 7 years of follow-up, 242 (8.91%) patients died. Cox regression analysis revealed that higher TGI levels were associated with a higher risk of long-term all-cause mortality in middle-aged participants (hazard ratio [HR], 3.64; 95% confidence interval [CI] 1.44–9.22, P = 0.006) but not in old participants (HR 1.20, 95% CI 0.62–2.32, P = 0.594, P for interaction = 0.017), after adjusting physical activity and other factors. Kaplan–Meier estimate analysis and restricted cubic spline curves showed similar results. Conclusion TGI was a promising marker for predicting all-cause mortality in middle-aged patients after cardiovascular diseases. Patients younger than 65 years old who have a higher level of TGI may develop a higher risk of all-cause mortality, and they are encouraged to control vascular risk factors and take more physical activity to improve their prognosis. Additionally, whether intervention in regulating TGI levels is beneficial for the prognosis of these patients needs further investigation.

Association between the triglyceride glucose index and atherosclerotic cardiovascular disease in the general population: analysis of the national health and nutrition examination survey 1999–2004

“…After a 7-year follow-up of 2923 patients with cardiovascular disease, Wang et al. found that the TyG levels were a promising marker for predicting the all-cause mortality in middle-aged patients, but not in elderly patients ( 48 ). Similarly, middle-aged patients with higher levels of TyG index awere more likely to experience major adverse cardiovascular events ( 49 ).…”

Is systemic inflammation a missing link between cardiometabolic index with mortality? Evidence from a large population-based study

“…Chen et al elucidated a positive association of the TyG index with all-cause (HR=1.160) and cardiovascular mortality (HR=1.213) in the overall population [ 32 ]. Wang et al suggested that the TyG index was a promising indicator for predicting all-cause mortality (HR=3.64) in patients younger than 65 years old with CVD [ 33 ]. Zhang et al observed U-shaped associations of the TyG index with all-cause and cardiovascular mortality in CVD patients with DM or pre-DM and the threshold TyG index values were 9.05 and 8.84 in all-cause mortality and cardiovascular mortality [ 34 ].…”

Triglyceride-glucose index predicts death in patients with stroke younger than 65

“…Ma et al discovered that patients below 70 years of age with elevated TGI levels exhibited an increased risk of cardiovascular and cerebrovascular diseases, including stroke, type 2 diabetes mellitus, and acute coronary syndrome, while no significant association was observed in older patients ( 46 ). Wang et al suggested that a higher level of TGI in patients below 65 years of age with cardiovascular diseases may indicate an elevated risk of all-cause death ( 47 ). To explore the impact of age on the association between TGI and clinical outcome after stroke, we categorized the study population into older and younger groups.…”

“…Previous research has investigated the effect of TGI in selecting people at early risk of future stroke who are seemingly healthy (47). To explore the impact of age on the association between TGI and clinical outcome after stroke, we categorized the study population into older and younger groups.…”