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