National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China.
Department of Cardiovascular Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Cardiovasc Diabetol. 2023 Aug 30;22(1):230. doi: 10.1186/s12933-023-01969-3.
The triglyceride-glucose (TyG) index has been evaluated as a reliable surrogate for insulin resistance (IR) and has been proven to be a predictor of poor outcomes in patients with cardiovascular diseases. However, data are lacking on the relationship of the TyG index with prognosis in nondiabetic patients who underwent coronary artery bypass grafting (CABG). Thus, the purpose of our current study was to investigate the potential value of the TyG index as a prognostic indicator in patients without diabetes mellitus (DM) after CABG.
This multicenter, retrospective cohort study involving 830 nondiabetic patients after CABG from 3 tertiary public hospitals from 2014 to 2018. Kaplan-Meier survival curve analysis was conducted followed by the log-rank test. Cox proportional hazards regression models were used to explore the association between the TyG index and major adverse cardiovascular events (MACEs). The incremental predictive power of the TyG index was evaluated with C-statistics, continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI).
An incrementally higher TyG index was associated with an increasingly higher cumulative incidence of MACEs (log-rank test, p < 0.001). The hazard ratio (95% CI) of MACEs was 2.22 (1.46-3.38) in tertile 3 of the TyG index and 1.38 (1.18-1.62) per SD increase in the TyG index. The addition of the TyG index yielded a significant improvement in the global performance of the baseline model [C-statistic increased from 0.656 to 0.680, p < 0.001; continuous NRI (95% CI) 0.269 (0.100-0.438), p = 0.002; IDI (95% CI) 0.014 (0.003-0.025), p = 0.014].
The TyG index may be an independent factor for predicting adverse cardiovascular events in nondiabetic patients after CABG.
三酰甘油-葡萄糖（TyG）指数已被评估为胰岛素抵抗（IR）的可靠替代指标，并已被证明是心血管疾病患者预后不良的预测指标。然而，在接受冠状动脉旁路移植术（CABG）的非糖尿病患者中，TyG 指数与预后的关系数据尚缺乏。因此，本研究的目的是探讨 TyG 指数作为 CABG 后非糖尿病患者预后指标的潜在价值。
这是一项多中心、回顾性队列研究，纳入了 2014 年至 2018 年来自 3 家三级公立医院的 830 例 CABG 后的非糖尿病患者。进行 Kaplan-Meier 生存曲线分析，然后进行对数秩检验。Cox 比例风险回归模型用于探讨 TyG 指数与主要不良心血管事件（MACEs）之间的关系。采用 C 统计量、连续净重新分类改善（NRI）和综合判别改善（IDI）评估 TyG 指数的增量预测能力。
TyG 指数逐渐升高与 MACEs 的累积发生率逐渐升高相关（对数秩检验，p<0.001）。TyG 指数三分位 3 的 MACEs 风险比（95%CI）为 2.22（1.46-3.38），TyG 指数每增加 1 SD 的风险比为 1.38（1.18-1.62）。TyG 指数的加入显著改善了基线模型的整体性能[C 统计量从 0.656 增加到 0.680，p<0.001；连续 NRI（95%CI）为 0.269（0.100-0.438），p=0.002；IDI（95%CI）为 0.014（0.003-0.025），p=0.014]。
TyG 指数可能是预测 CABG 后非糖尿病患者不良心血管事件的独立因素。
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