三酰甘油葡萄糖指数与慢性完全闭塞病变冠心病患者侧支循环的关系。
Association between the triglyceride glucose index and coronary collateralization in coronary artery disease patients with chronic total occlusion lesions.
机构信息
Department of cardiology, Beijing AnZhen Hospital, Capital Medical University, 100029, Beijing, China.
Beijing Institute of Heart Lung and Blood Vessel Disease, 100029, Beijing, China.
出版信息
Lipids Health Dis. 2021 Oct 25;20(1):140. doi: 10.1186/s12944-021-01574-x.
BACKGROUND
Recent studies have substantiated the role of the triglyceride glucose (TyG) index in predicting the prognosis of coronary artery disease (CAD) patients, while no relevant studies have revealed the association between the TyG index and coronary collateralization in the event of coronary chronic total occlusion (CTO). The current study intends to explore whether, or to what extent, the TyG index is associated with impaired collateralization in CAD patients with CTO lesions.
METHODS
The study enrolled 1093 CAD patients undergoing cardiac catheterization for at least one CTO lesion. Data were collected from the Beijing Anzhen Hospital record system. The degree of collaterals was determined according to the Rentrop classification system. The correlation between the TyG index and coronary collateralization was assessed.
RESULTS
Overall, 318 patients were included in a less developed collateralization (Rentrop classification 0-1) group. The TyG index was significantly higher in patients with impaired collateralization (9.3±0.65 vs. 8.8±0.53, P<0.001). After adjusting for various confounding factors, the TyG index remained correlated with the occurrence of impaired collateralization, with odds ratios (ORs) of 1.59 and 5.72 in the T2 and T3 group compared with the first tertile group (P<0.001). In addition, subgroup analysis showed that higher TyG index values remained strongly associated with increased risk of less developed collateralization. To compare the risk assessment efficacy for the formation of collateralization between the TyG index and other metabolic abnormality indicators, an area under the receiver-operating characteristic (ROC) curve (AUC) was obtained. A significant improvement in the risk assessment performance for impaired collateralization emerged when adding the TyG index into a baseline model.
CONCLUSIONS
The increased TyG index is strongly associated with less developed collateralization in CAD patients with CTO lesions and its risk assessment performance is better than single metabolic abnormality indicators.
背景
最近的研究证实了甘油三酯-葡萄糖（TyG）指数在预测冠状动脉疾病（CAD）患者预后中的作用，而没有相关研究表明 TyG 指数与冠状动脉慢性完全闭塞（CTO）事件中的冠状侧支循环之间存在关联。本研究旨在探讨 TyG 指数与 CTO 病变 CAD 患者受损侧支循环之间是否存在关联，以及关联程度如何。
方法
本研究纳入了 1093 名因至少一条 CTO 病变而行心脏导管检查的 CAD 患者。数据来自北京安贞医院的病历系统。根据 Rentrop 分级系统确定侧支循环的程度。评估 TyG 指数与冠状动脉侧支循环之间的相关性。
结果
总体而言，318 例患者存在侧支循环较差（Rentrop 分级 0-1）。侧支循环受损患者的 TyG 指数明显较高（9.3±0.65 比 8.8±0.53，P<0.001）。在校正了各种混杂因素后，TyG 指数与侧支循环受损的发生仍相关，与第一三分位组相比，T2 组和 T3 组的比值比（ORs）分别为 1.59 和 5.72（P<0.001）。此外，亚组分析显示，较高的 TyG 指数值与侧支循环较差的风险增加仍存在强相关性。为了比较 TyG 指数与其他代谢异常指标对侧支循环形成的风险评估效能，获得了受试者工作特征（ROC）曲线下面积（AUC）。在基线模型中加入 TyG 指数后，侧支循环受损的风险评估性能显著提高。
结论
TyG 指数升高与 CTO 病变 CAD 患者侧支循环较差密切相关，其风险评估效能优于单一代谢异常指标。
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