Neglia Danilo, Aimo Alberto, Lorenzoni Valentina, Caselli Chiara, Gimelli Alessia
Fondazione CNR/Regione Toscana Gabriele Monasterio, Cardiovascular and Imaging Departments, CNR Research Area, Via G. Moruzzi 1, Pisa 56124, Italy.
Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, Pisa 56127, Italy.
Eur Heart J Open. 2021 Jul 24;1(1):oeab004. doi: 10.1093/ehjopen/oeab004. eCollection 2021 Aug.
The triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance (IR), is a prognostic risk factor in the general population. We aimed to assess whether it is an independent predictor of outcome also in patients with chronic coronary syndrome (CCS).
TyG index was evaluated in 1097 consecutive patients (75% men, median age 72 years) with known (26%) or suspected coronary artery disease (CAD), undergoing stress-rest myocardial perfusion scintigraphy, and coronary angiography and followed up for a median of 4.5 years. Moderate/severe perfusion abnormalities during stress (summed stress score >7) were documented in 60% of patients, obstructive CAD in 74%, and 36% underwent early revascularization. TyG index was 8.9 (median, interquartile interval 8.6-9.2). Cardiac death or myocardial infarction occurred in 103 patients and all-cause death in 65. After correction for clinical risk factors, LV function and common bio-humoral variables, TyG index (HR 2.42, 95% CI 1.57-3.72, < 0.001), and moderate/severe stress perfusion abnormalities (hazard ratio (HR) 2.17, 95% confidence interval (CI) 1.25-3.77, < 0.001) independently predicted cardiac events. TyG index (HR 3.64, 95%CI 2.22-5.96, < 0.001) and high-sensitivity C-reactive protein (HR 1.11, 95% CI 1.04-1.19, = 0.002) independently predicted all-cause death.
In patients with CCS, the TyG index identifies a cardiometabolic profile associated with an additional risk of cardiac events, over the presence of myocardial ischaemia and independently of other clinical, common bio-humoral or imaging risk determinants.
甘油三酯-葡萄糖（TyG）指数作为胰岛素抵抗（IR）的替代标志物，是一般人群的预后危险因素。我们旨在评估它是否也是慢性冠状动脉综合征（CCS）患者预后的独立预测指标。
对1097例连续的已知（26%）或疑似冠心病（CAD）患者（75%为男性，中位年龄72岁）进行评估，这些患者接受了静息-负荷心肌灌注显像、冠状动脉造影，并进行了中位时间为4.5年的随访。60%的患者在负荷时出现中度/重度灌注异常（负荷总分>7），74%的患者存在阻塞性CAD，36%的患者接受了早期血运重建。TyG指数为8.9（中位数，四分位间距8.6 - 9.2）。103例患者发生心源性死亡或心肌梗死，65例患者发生全因死亡。在校正临床危险因素、左心室功能和常见生物体液变量后，TyG指数（风险比[HR] 2.42，95%置信区间[CI] 1.57 - 3.72，P < 0.001）和中度/重度负荷灌注异常（风险比[HR] 2.17，95%置信区间[CI] 1.25 - 3.77，P < 0.001）独立预测心脏事件。TyG指数（HR 3.64，95%CI 2.22 - 5.96，P < 0.001）和高敏C反应蛋白（HR 1.11，95%CI 1.
