National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, China.
J Diabetes. 2024 Aug;16(8):e13589. doi: 10.1111/1753-0407.13589.
The triglyceride-glucose (TyG) index and high-sensitivity C-reactive protein (hsCRP) are the commonly used biomarkers for insulin resistance and systemic inflammation, respectively. We aimed to investigate the combined association of TyG and hsCRP with the major adverse cardiovascular events (MACE) in patients with chronic coronary syndrome (CCS).
A total of 9421 patients with CCS were included in this study. The primary endpoint was defined as a composite of MACE covering all-cause death, nonfatal myocardial infarction, and revascularization.
During the 2-year follow-up period, 660 (7.0%) cases of MACE were recorded. Participants were divided equally into three groups according to TyG levels. Compared with the TyG T1 group, the risk of MACE was significantly higher in the TyG T3 group. It is noteworthy that among patients in the highest tertile of TyG, hsCRP >3 mg/L was significantly associated with an increased risk of MACE, whereas the results were not significant in the medium to low TyG groups. When patients were divided into six groups according to hsCRP and TyG, the Cox regression analysis showed that patients in the TyG T3 and hsCRP >3 mg/L group had a significantly higher risk of MACE than those in the TyG T1 and hsCRP ≤3 mg/L group. However, no significant interaction was found between TyG and hsCRP on the risk of MACE.
Our study suggests that the concurrent assessment of TyG and hsCRP may be valuable in identifying high-risk populations and guiding management strategies among CCS patients.
甘油三酯-葡萄糖(TyG)指数和高敏 C 反应蛋白(hsCRP)分别是胰岛素抵抗和全身炎症的常用生物标志物。我们旨在探讨 TyG 和 hsCRP 与慢性冠脉综合征(CCS)患者主要不良心血管事件(MACE)的联合相关性。
本研究共纳入 9421 例 CCS 患者。主要终点定义为包括全因死亡、非致死性心肌梗死和血运重建在内的 MACE 复合终点。
在 2 年的随访期间,记录到 660 例(7.0%)MACE 病例。根据 TyG 水平将参与者平均分为三组。与 TyG T1 组相比,TyG T3 组的 MACE 风险显著升高。值得注意的是,在 TyG 最高三分位的患者中,hsCRP >3mg/L 与 MACE 风险增加显著相关,而在中低 TyG 组则无显著相关性。当根据 hsCRP 和 TyG 将患者分为六组时,Cox 回归分析显示 TyG T3 和 hsCRP >3mg/L 组的患者发生 MACE 的风险明显高于 TyG T1 和 hsCRP ≤3mg/L 组。然而,TyG 和 hsCRP 之间并未发现 MACE 风险的显著交互作用。
我们的研究表明,同时评估 TyG 和 hsCRP 可能有助于识别 CCS 患者中的高危人群,并指导管理策略。