Zhang J W, Hua K, Yang X B
Department of Structural Heart Disease Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Zhonghua Yi Xue Za Zhi. 2023 Jun 13;103(22):1673-1678. doi: 10.3760/cma.j.cn112137-20230216-00219.
To investigate the predictive value of preoperative triglyceride-glucose (TyG) index on atrial fibrillation recurrence after valvular surgery with concurrent Cox-maze Ⅳ ablation. The data of the patients who underwent valvular surgery with concurrent Cox-maze Ⅳ ablation from June 2017 to May 2022 in the Department of Cardiac Surgery, Beijing Anzhen Hospital were retrospectively collected, and the patients were divided into the recurrence group and non-recurrence group. Baseline clinical data and results of laboratory tests were collected and TyG index was calculated. The univariate and multivariate Cox proportional regression analysis were used to explore the risk factors of atrial fibrillation recurrence after Cox-maze Ⅳ ablation. The value of TyG index in predicting atrial fibrillation recurrence was obtained by plotting receiver operating characteristic (ROC) curve. A total of 424 patients were in the final analysis, including 300 males and 124 females, with an average age of (58.2±13.4) years. The median follow-up time was 32.7 months (17.3-49.6 months). There were 117 and 307 patients in the recurrence and non-recurrence groups, respectively. Compared with the non-recurrence group, the TyG index in the recurrence group was higher (9.21±0.38 vs 8.34±0.72, =0.011). The multivariate Cox regression analysis showed that TyG index (=2.021, 95%: 1.374-3.245, <0.001), C-reactive protein level (=1.127, 95%: 1.007-1.535, =0.026) and mitral stenosis (=1.038, 95%: 1.004-1.483, <0.001) were risk factors for atrial fibrillation recurrence after Cox-maze Ⅳ ablation. In addition, TyG index was a predictor of atrial fibrillation recurrence according to ROC curve analysis [area under the curve (AUC)=0.847, 95%: 0.796-0.871, <0.001]. The TyG index is an effective indicator to predict the recurrence of atrial fibrillation after valvular surgery with concurrent Cox-maze Ⅳ ablation.
探讨术前甘油三酯-葡萄糖(TyG)指数对瓣膜手术同期Cox迷宫Ⅳ消融术后房颤复发的预测价值。回顾性收集2017年6月至2022年5月在北京安贞医院心脏外科接受瓣膜手术同期Cox迷宫Ⅳ消融的患者资料,将患者分为复发组和非复发组。收集基线临床资料和实验室检查结果并计算TyG指数。采用单因素和多因素Cox比例回归分析探讨Cox迷宫Ⅳ消融术后房颤复发的危险因素。通过绘制受试者工作特征(ROC)曲线获得TyG指数预测房颤复发的价值。最终纳入分析424例患者,其中男性300例,女性124例,平均年龄(58.2±13.4)岁。中位随访时间为32.7个月(17.3 - 49.6个月)。复发组和非复发组分别有117例和307例患者。与非复发组相比,复发组的TyG指数更高(9.21±0.38 vs 8.34±0.72,P = 0.011)。多因素Cox回归分析显示,TyG指数(P = 2.021,95%CI:1.374 - 3.245,P < 0.001)、C反应蛋白水平(P = 1.127,95%CI:1.007 - 1.535,P = 0.026)和二尖瓣狭窄(P = 1.038,95%CI:1.004 - 1.483,P < 0.001)是Cox迷宫Ⅳ消融术后房颤复发的危险因素。此外,根据ROC曲线分析,TyG指数是房颤复发的预测指标[曲线下面积(AUC)= 0.847,95%CI:0.796 - 0.871,P < 0.001]。TyG指数是预测瓣膜手术同期Cox迷宫Ⅳ消融术后房颤复发的有效指标。