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甘油三酯-葡萄糖指数与中国经皮冠状动脉介入治疗后心血管结局的关系:一项荟萃分析。

Triglyceride-glucose index's link to cardiovascular outcomes post-percutaneous coronary intervention in China: a meta-analysis.

机构信息

Beijing University of Chinese Medicine, Beijing, China.

National Clinical Research Center for Chinese Medicine Cardiology, China Academy of Chinese Medical Sciences, Xiyuan Hospital, Beijing, China.

出版信息

ESC Heart Fail. 2024 Jun;11(3):1317-1328. doi: 10.1002/ehf2.14679. Epub 2024 Jan 21.

Abstract

Percutaneous coronary intervention (PCI) addresses myocardial ischaemia, but a significant subset of patients encounter major adverse cardiovascular events (MACE) post-treatment. This meta-analysis investigated the relationship between the post-PCI triglyceride-glucose (TyG) index and MACE. Comprehensive searches of the Embase, PubMed, Cochrane Library, and Web of Science databases were conducted up to 3 March 2023, using relevant keywords. The effect size was determined based on I statistic using random-effects models. Cluster-robust standard errors crafted the dose-response curve, and the GRADE Evaluation Scale was employed to rate the quality of evidence. The group with the highest TyG index had significantly higher post-PCI MACE rates than the lowest index group, with hazard ratios (HRs) of 2.04 (95% CI 1.65-2.52; I = 77%). Each unit increase in TyG index corresponded to HRs of 1.82 for MACE (95% CI 1.34-2.46; I = 92%), 2.57 for non-fatal MI (95% CI 1.49-4.41; I = 63%), and 2.06 for revascularization (95% CI 1.23-3.50; I = 90%). A linear relationship between TyG index and MACE risk was established (R = 0.6114). For all-cause mortality, the HR was 1.93 (95% CI 1.35-2.75; I = 50%), indicating a higher mortality risk with elevated TyG index. The GRADE assessment yielded high certainty for non-fatal MI but low certainty for all-cause mortality, revascularization, and MACE. The TyG index may predict risks of post-PCI MACE, all-cause mortality, non-fatal MI, and revascularization, with varied levels of certainty. A potential linear association between the TyG index and MACE post-PCI was identified. Future research should validate these findings.

摘要

经皮冠状动脉介入治疗(PCI)可解决心肌缺血问题,但相当一部分患者在治疗后会出现主要不良心血管事件(MACE)。本荟萃分析研究了 PCI 后甘油三酯-葡萄糖(TyG)指数与 MACE 之间的关系。从 2023 年 3 月 3 日起,我们在 Embase、PubMed、Cochrane 图书馆和 Web of Science 数据库中进行了全面检索,并使用了相关的关键词。使用随机效应模型根据 I 统计量确定效应大小。聚类稳健标准误差构建了剂量-反应曲线,使用 GRADE 评估量表对证据质量进行评级。TyG 指数最高的组 PCI 后 MACE 发生率明显高于指数最低的组,风险比(HR)为 2.04(95%CI 1.65-2.52;I=77%)。TyG 指数每增加一个单位,MACE 的 HR 相应增加 1.82(95%CI 1.34-2.46;I=92%)、非致死性心肌梗死(MI)的 HR 增加 2.57(95%CI 1.49-4.41;I=63%)和血运重建的 HR 增加 2.06(95%CI 1.23-3.50;I=90%)。TyG 指数与 MACE 风险之间存在线性关系(R=0.6114)。对于全因死亡率,HR 为 1.93(95%CI 1.35-2.75;I=50%),表明 TyG 指数升高会增加全因死亡率的风险。GRADE 评估结果表明,非致死性 MI 的确定性为高,而全因死亡率、血运重建和 MACE 的确定性为低。TyG 指数可能预测 PCI 后 MACE、全因死亡率、非致死性 MI 和血运重建的风险,确定性程度不一。确定了 PCI 后 TyG 指数与 MACE 之间存在潜在的线性关联。未来的研究应该验证这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820d/11098636/0eb20f4ab308/EHF2-11-1317-g002.jpg

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