高甘油三酯-葡萄糖指数与中国急性冠脉综合征且未合并糖尿病的经皮冠状动脉介入治疗患者的不良心血管结局相关。
High triglyceride-glucose index is associated with poor cardiovascular outcomes in Chinese acute coronary syndrome patients without diabetes mellitus who underwent emergency percutaneous coronary intervention with drug-eluting stents.
机构信息
Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Department of Cardiovascular Medicine, Weinan Central Hospital, Weinan, Shaanxi, China.
出版信息
Front Endocrinol (Lausanne). 2023 Feb 15;14:1101952. doi: 10.3389/fendo.2023.1101952. eCollection 2023.
BACKGROUND
Previous research has supported the association between the triglyceride-glucose index (TyG index) and the incidence and prognosis of cardiovascular disease. However, the association between the TyG index and the prognosis of patients with acute coronary syndrome (ACS) without diabetes mellitus (DM) who underwent emergency percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) has not been thoroughly investigated, and these patients may easily be neglected. Therefore, this study aimed to investigate the association between the TyG index and major adverse cardiovascular and cerebrovascular events (MACCEs) in Chinese ACS patients without DM who underwent emergency PCI with DES.
METHODS
The total number of ACS patients without DM who underwent emergency PCI with DES for this study was 1650. Ln [fasting triglycerides (mg/dL) ×fasting plasma glucose (mg/dL)/2] is the formula used to calculate the TyG index. According to the TyG index, we classified the patients into two groups. The frequency of the following endpoint events was calculated and compared between the two groups: all-cause death, non-fatal myocardial infarction (MI), non-fatal ischemia stroke, ischemia-driven revascularization and cardiac rehospitalization.
RESULTS
After a median of 47 months of follow-up [47 (40, 54)], 437 (26.5%) endpoint events were recorded in total. The TyG index was further demonstrated to be independent of MACCE by multivariable Cox regression analysis (hazard ratio [HR], 1.493; 95% confidence interval [CI], 1.230-1.812; 0.001). The TyG index≥7.08 group had a considerably greater incidence of MACCE (30.3% vs. 22.7% in the TyG index<7.08 group, <0.001), cardiac death (4.0% vs. 2.3% in the TyG index<7.08 group, =0.047), and ischemia-driven revascularization (5.7% vs. 3.6% in the TyG index<7.08 group, =0.046) than the TyG index<7.08 group. Between the two groups, there was no discernible difference in all-cause death (5.6% vs. 3.8% in the TyG index<7.08 group, =0.080), non-fatal MI (1.0% vs. 0.2% in the TyG index<7.08 group, =0.057), non-fatal ischemic stroke (1.6% vs. 1.0% in the TyG index<7.08 group, =0.272), and cardiac rehospitalization (16.5% vs. 14.1% in the TyG index<7.08 group, =0.171).
CONCLUSION
For ACS patients without DM who received emergency PCI with DES, the TyG index might be an independent predictor of MACCE.
背景
先前的研究支持三酰甘油-葡萄糖指数（TyG 指数）与心血管疾病的发病和预后之间的关联。然而，在接受药物洗脱支架（DES）急诊经皮冠状动脉介入治疗（PCI）的无糖尿病（DM）急性冠状动脉综合征（ACS）患者中，TyG 指数与预后之间的关联尚未得到充分研究，这些患者可能容易被忽视。因此，本研究旨在探讨 TyG 指数与中国无 DM 的 ACS 患者接受 DES 急诊 PCI 后主要不良心脑血管事件（MACCEs）之间的关系。
方法
这项研究共纳入了 1650 名无 DM 的接受 DES 急诊 PCI 的 ACS 患者。Ln[空腹三酰甘油（mg/dL）×空腹血糖（mg/dL）/2]是计算 TyG 指数的公式。根据 TyG 指数，我们将患者分为两组。计算并比较两组之间以下终点事件的发生频率：全因死亡、非致死性心肌梗死（MI）、非致死性缺血性卒中、缺血驱动的血运重建和心脏再入院。
结果
中位随访时间为 47 个月[47（40，54）]后，共记录到 437 例（26.5%）终点事件。多变量 Cox 回归分析进一步表明，TyG 指数是 MACCE 的独立预测因子（风险比[HR]，1.493；95%置信区间[CI]，1.230-1.812；0.001）。TyG 指数≥7.08 组的 MACCE 发生率明显更高（30.3% vs. TyG 指数<7.08 组的 22.7%，<0.001）、心脏死亡（4.0% vs. TyG 指数<7.08 组的 2.3%，=0.047）和缺血驱动的血运重建（5.7% vs. TyG 指数<7.08 组的 3.6%，=0.046）高于 TyG 指数<7.08 组。两组之间，全因死亡（5.6% vs. TyG 指数<7.08 组的 3.8%，=0.080）、非致死性 MI（1.0% vs. TyG 指数<7.08 组的 0.2%，=0.057）、非致死性缺血性卒中（1.6% vs. TyG 指数<7.08 组的 1.0%，=0.272）和心脏再入院（16.5% vs. TyG 指数<7.08 组的 14.1%，=0.171）无明显差异。
结论
对于接受 DES 急诊 PCI 的无 DM 的 ACS 患者，TyG 指数可能是 MACCE 的独立预测因子。
Zotero 插件