Triglyceride-glucose index for predicting repeat revascularization and in-stent restenosis in patients with chronic coronary syndrome undergoing percutaneous coronary intervention

Abstract

Background The triglyceride-glucose (TyG) index, a reliable surrogate indicator of insulin resistance, is independently associated with coronary artery disease of various clinical manifestations. This study aimed to investigate the prognostic value of the TyG index in predicting repeat revascularization and in-stent restenosis (ISR) in chronic coronary syndrome (CCS) patients undergoing percutaneous coronary intervention (PCI). Methods A total of 1414 participants were enrolled and divided into groups according to the tertiles of the TyG index. The primary endpoint was a composite of PCI complications, including repeat revascularization and ISR. The associations between the TyG index and the primary endpoint were assessed by multivariable Cox proportional hazards regression analysis with restricted cubic splines (RCS). The TyG index was calculated as Ln (fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2). Results Over a median follow-up of 60 months, 548 (38.76%) patients had experienced at least one primary endpoint event. The follow-up incidence of the primary endpoint increased with the TyG index tertiles. After adjusting for potential confounders, the TyG index was independently associated with the primary endpoint in CCS patients (HR, 1.191; 95% CI 1.038–1.367; P = 0.013). Additionally, the highest tertile of the TyG group was correlated with a 1.319-fold risk of the primary endpoint compared with the lowest tertile of the TyG group (HR, 1.319; 95% CI 1.063–1.637; P = 0.012). Furthermore, a linear and dose–response relationship was observed between the TyG index and the primary endpoint (non-linear P = 0.373, P overall = 0.035). Conclusions An increased TyG index was associated with elevated risk for long-term PCI complications, including repeat revascularization and ISR. Our study suggested that the TyG index could be a potent predictor in evaluating the prognosis of CCS patients undergoing PCI.

High triglyceride-glucose index and stress hyperglycemia ratio as predictors of adverse cardiac events in patients with coronary chronic total occlusion: a large-scale prospective cohort study

“…The association between Tyg index levels and CVD was comprehensively discussed, and its predictive value for a high incidence of CHD has been extensively revealed in previous cohort studies and meta-analyses [ 20 , 21 ]. Regarding the prognostic value of the TyG index in CHD patients, several cohort studies showed that patients with a high TyG index were independently associated with a high risk of repeat revascularization and hospital mortality [ 22 , 23 ]. With respect to CTO, the prognostic role of the TyG index in patients with CTO lesions was previously investigated by several studies; however, the sample size of these studies was not satisfactory, and the evidence was not sufficient.…”

The association between triglyceride glucose index and arthritis: a population-based study

“…Ahn et al [ 30 ] discovered a significant positive association between the TyG index and a low skeletal muscle mass index in Korean participants. According to the findings of Guo et al [ 31 ], an elevated TyG index was associated with a higher risk of long-term complications following percutaneous coronary intervention, such as repeat revascularization and in-stent restenosis. The results presented by Guo et al highlight the clinical relevance of the TyG index in identifying individuals at higher risk for adverse outcomes after percutaneous coronary intervention and emphasize its potential as a valuable tool in risk assessment and patient management within the context of chronic coronary syndrome.…”

Glycemic control and cardiovascular outcomes in patients with diabetes and coronary artery disease according to triglyceride-glucose index: a large-scale cohort study

“…The relationship between TyG index and CAD has been thoroughly examined, and previous cohort studies and meta-analyses have extensively demonstrated its predictive value for a high incidence of CAD [ 30 , 31 ]. For CAD patients, multiple cohort studies have indicated that individuals with a high TyG index are independently associated with an increased risk of repeated revascularization and in-hospital mortality [ 32 , 33 ]. For diabetic patients, one previous study has indicated TyG index was associated with the all-cause mortality risk in patients with diabetes or pre-diabetes [ 34 ].…”