Department of Cardiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Department of Nephrology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
ESC Heart Fail. 2024 Oct;11(5):3120-3132. doi: 10.1002/ehf2.14898. Epub 2024 Jun 12.
The triglyceride-glucose (TyG) index has demonstrated correlations with adverse clinical outcomes in patients with ischaemic stroke, coronary heart disease and cardiac failure. However, its association with overall mortality in individuals concurrently experiencing heart failure (HF) and chronic kidney disease (CKD) remains inadequately explored.
Utilizing the Medical Information Mart for Intensive Care IV (Version 2.2) repository, subjects underwent quartile stratification based on the TyG index. The primary endpoint was all-cause mortality during hospitalization. Cox proportional hazard models were employed to examine the correlation between TyG and all-cause mortality in HF patients with CKD. Evaluation involved Kaplan-Meier (KM) analysis and restricted cubic splines (RCSs) to compare mortality rates during hospitalization and 1 year after admission across cohorts with varying TyG index levels.
A cohort of 1537 HF and CKD patients participated. Cox regression analysis revealed elevated TyG levels as an independent risk factor for both in-hospital and 1 year mortality. RCS analysis indicated a rising, non-linear association between TyG levels and all-cause mortality (P value for non-linear <0.001). KM survival curves demonstrated a statistically significant reduction in survival rates within the high TyG index group compared with the low one (log-rank P < 0.001).
The TyG index exhibited substantial independent prognostic value for elevated in-hospital and 1 year all-cause mortality among the cohort with HF and CKD. These findings suggest that assessing the TyG index could play a crucial role in developing novel therapeutic strategies to improve outcomes for this high-risk demographic.
甘油三酯-葡萄糖（TyG）指数与缺血性脑卒中、冠心病和心力衰竭患者的不良临床结局相关。然而，其与同时患有心力衰竭（HF）和慢性肾脏病（CKD）的个体全因死亡率的相关性尚未得到充分探讨。
利用医疗信息集市重症监护 IV（版本 2.2）数据库，根据 TyG 指数对受试者进行四分位分层。主要终点是住院期间的全因死亡率。采用 Cox 比例风险模型研究 TyG 与 CKD 合并 HF 患者全因死亡率之间的相关性。评估包括 Kaplan-Meier（KM）分析和限制立方样条（RCS），以比较不同 TyG 指数水平的队列在住院期间和入院后 1 年的死亡率。
共纳入 1537 例 HF 和 CKD 患者。Cox 回归分析显示，TyG 水平升高是住院和 1 年死亡率的独立危险因素。RCS 分析表明，TyG 水平与全因死亡率之间存在上升的非线性关系（非线性 P 值<0.001）。KM 生存曲线显示，高 TyG 指数组的生存率明显低于低 TyG 指数组（对数秩 P<0.001）。
TyG 指数对 HF 和 CKD 患者住院期间和 1 年全因死亡率升高具有显著的独立预后价值。这些发现表明，评估 TyG 指数可能在制定针对这一高危人群的新治疗策略方面发挥关键作用，以改善其预后。
