The association between triglyceride glucose-body mass index and all-cause mortality in critically ill patients with atrial fibrillation: a retrospective study from MIMIC-IV database

Abstract

Background The TyG-BMI index, which is a reliable indicator of insulin resistance (IR), has been found to have a significant correlation with the occurrence of cardiovascular events. However, there still lacks study on the TyG-BMI index and prognosis in patients with atrial fibrillation (AF). The objective of the present study was to evaluate the relationship between TyG-BMI index at admission to ICU and all-cause mortality in critically ill patients with AF. Methods The patient’s data were extracted from Medical Information Mart for Intensive Care IV(MIMIC-IV) database. All patients were divided into four groups according to TyG-BMI index. Outcomes include primary and secondary endpoints, with the primary endpoint being the 30-day and 365-day all-cause mortality and the secondary endpoint being the 90-day and 180-day all-cause mortality. TyG-BMI index was quartile and Kaplan-Meier curve was used to compare the outcome of each group. Cox proportional-hazards regression model and restricted cubic splines (RCS) were conducted to assess the relationship between TyG-BMI index and outcomes. Results Out of a total of 2509 participants, the average age was 73.26 ± 11.87 years, with 1555 (62.0%) being males. Patients with lower level of TyG-BMI had higher risk of 30-day, 90-day, 180-day and 365-day all-cause mortality, according to the Kaplan-Meier curves (log-rank P < 0.001). In addition, cox proportional-hazards regression analysis revealed that the risk of 30-day, 90-day, 180-day and 365-day all-cause mortality was significantly higher in the lowest quartile of TyG-BMI. Meanwhile, the RCS analysis indicated that L-typed relationships between TyG-BMI index and all-cause mortality, with inflection points at 223.60 for 30-day and 255.02 for 365-day all-cause mortality, respectively. Compared to patients with TyG-BMI levels below the inflection points, those with higher levels had a 1.8% lower risk for 30-day all-cause mortality (hazard ratio [HR] 0.982, 95% confidence interval [CI] 0.9676–0.988) and 1.1% lower risk for 365-day all-cause mortality (HR 0.989, 95% CI 0.986–0.991). Conclusion In critically ill patients with AF, a lower TyG-BMI level is significantly associated with a higher risk of 30-day, 90-day, 180-day and 365-day all-cause mortality. TyG-BMI index could be used as a valid indicator for grading and treating patients with AF in the ICU.

Long-term survival in stroke patients: insights into triglyceride-glucose body mass index from ICU data

“…Conversely, among stroke survivors, diminished TyG-BMI levels may reflect severe malnutrition or metabolic exhaustion, conditions that are intimately linked with disease severity and an elevated mortality risk. Our findings corroborate the hypothesis of a significant negative correlation between TyG-BMI and ACM in critically ill stroke patients, aligning with previous studies [21,38]. This alignment underscores the importance of TyG-BMI levels within the specific health trajectory of critically ill stroke patients, differentiating their risk profile from that of the general population.…”

“…The combined TyG-BMI metric is a valuable tool for assessing IR [18,[21][22][23][24]31], demonstrating its utility in evaluating major adverse cardiovascular event risk, particularly in patients having ST-elevation myocardial infarction (STEMI) and those with pre-HTN or HTN [32,33]. Moreover, elevated TyG-BMI levels have been found to be related to an increased stroke incidence, though this relationship has primarily been documented within the Chinese population, highlighting the need for further research across different ethnicities to corroborate these findings [21][22][23][24]. The significance of the TyG-BMI in forecasting cardiovascular incidents and stroke risk is well-documented.…”

“…The combined TyG-BMI, particularly, has shown promising alignment with HOMA-IR in evaluating IR [17] and is closely linked to HTN prevalence, non-alcoholic fatty liver disorder, and cardiovascular outcomes in coronary artery disease patients [18][19][20]. Based on the study of TyG-BMI and mortality in critically ill atrial fibrillation patients [21], We hypothesis that a significant negative association between TyG-BMI and ACM among critically ill stroke patients still existed. While the TyG-BMI's positive association with stroke risk in the Chinese general population has been documented [22][23][24], its impact on outcomes for stroke patients in the ICU remains underexplored.…”

Association between triglyceride glucose body mass index and cardiovascular disease in adults: evidence from NHANES 2011- 2020

“…Moreover, a well-established link exists between IR and atherosclerosis ( 31 ), a key CVD risk factor, with the TyG-BMI index as an effective CVD predictor. A study by Yi Hu indicates an L-shaped association between TyG-BMI and all-cause mortality in patients with atrial fibrillation admitted to the ICU ( 15 ). According to surveys, individuals with heart failure can also utilize the TyG-BMI index to predict their one-year all-cause mortality ( 32 ).…”