Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University.
Clinical Atherosclerosis Research Lab, Division of Cardiology, University of Washington.
J Atheroscler Thromb. 2022 Feb 1;29(2):268-281. doi: 10.5551/jat.61119. Epub 2021 Feb 3.
To evaluate the prognostic value of triglyceride-glucose (TyG) index in nondiabetic patients with acute coronary syndrome (ACS) with low-density lipoprotein cholesterol (LDL-C) below 1.8 mmol/L.
A total of 1655 nondiabetic patients with ACS with LDL-C below 1.8 mmol/L were included in the analysis. Patients were stratified into two groups. The incidence of acute myocardial infarction (AMI), infarct size in patients with AMI, and major adverse cardiac and cerebral event during a median of 35.6-month follow-up were determined and compared between the two groups. The TyG index was calculated using the following formula: ln [fasting triglycerides (mg/dL)×fasting plasma glucose (mg/dL)/2].
Compared with the TyG index ＜8.33 group, the TyG index ≥ 8.33 group had a significantly higher incidence of AMI (21.2% vs. 15.2%, p=0.014) and larger infarct size in patients with AMI [the peak value of troponin I: 10.4 vs. 4.8 ng/ml, p=0.003; the peak value of Creatine kinase MB: 52.8 vs. 22.0 ng/ml, p=0.006; the peak value of myoglobin: 73.7 vs. 46.0 ng/ml, p=0.038]. Although there was no significant difference in mortality between the two groups, the incidence of revascularization of the TyG index ≥ 8.33 group was significantly higher than that of the TyG index ＜8.33 group (8.9% vs. 5.0%, p=0.035). A multivariable Cox regression revealed that the TyG index was positively associated with revascularization [hazard ratio, 1.67; 95% confidence interval, 1.02-2.75; p=0.043].
In nondiabetic patients with ACS with LDL-C below 1.8 mmol/L, a high TyG index level was associated with higher incidence of AMI, larger infarct size, and higher incidence of revascularization. A high TyG index level might be a valid predictor of subsequent revascularization.
评估非糖尿病急性冠状动脉综合征（ACS）患者中三酰甘油-葡萄糖（TyG）指数在低密度脂蛋白胆固醇（LDL-C）＜1.8mmol/L 时的预后价值。
共纳入 1655 例 LDL-C＜1.8mmol/L 的非糖尿病 ACS 患者进行分析。将患者分为两组。比较两组间急性心肌梗死（AMI）发生率、AMI 患者梗死面积以及中位随访 35.6 个月期间主要不良心脑事件。TyG 指数采用以下公式计算：ln[空腹三酰甘油（mg/dL）×空腹血糖（mg/dL）/2]。
与 TyG 指数＜8.33 组相比，TyG 指数≥8.33 组 AMI 发生率显著升高（21.2%比 15.2%，p=0.014），AMI 患者梗死面积更大[肌钙蛋白 I 峰值：10.4ng/ml 比 4.8ng/ml，p=0.003；肌酸激酶同工酶 MB 峰值：52.8ng/ml 比 22.0ng/ml，p=0.006；肌红蛋白峰值：73.7ng/ml 比 46.0ng/ml，p=0.038]。两组间死亡率无显著差异，但 TyG 指数≥8.33 组血运重建发生率显著高于 TyG 指数＜8.33 组（8.9%比 5.0%，p=0.035）。多变量 Cox 回归显示 TyG 指数与血运重建呈正相关[风险比，1.67；95%置信区间，1.02-2.75；p=0.043]。
在 LDL-C＜1.8mmol/L 的非糖尿病 ACS 患者中，高 TyG 指数水平与 AMI 发生率较高、梗死面积较大及血运重建发生率较高相关。高 TyG 指数水平可能是血运重建的有效预测指标。
