Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, China.
Lipids Health Dis. 2024 Aug 22;23(1):263. doi: 10.1186/s12944-024-02252-4.
Triglyceride-glucose (TyG) index is linked to a poor prognosis for cardiovascular condition and is a valid indicator of insulin resistance. This study evaluated the potential predicting usefulness of the TyG index for all-cause mortality, both short- and long-term, for those concerning critical coronary artery disease (CAD).
In this study, information from 5452 critically-ill individuals with CAD in intensive care units were gathered from the Medical Information Marketplace in Intensive Care (MIMIC-IV) database. Depending on the TyG index degree, the patients were categorized into three categories. Clinical outcomes included short-term (30-day) and long-term (365-day) all-cause mortality. The corresponding relationships involving the TyG index and clinical outcomes were examined by deploying restricted cubic spline (RCS) regression analysis and Cox proportional risk regression.
An increased TyG index was associated with increased 30-day (Tertile 1: 6.1%, Tertile 2: 7.3%, Tertile 3: 9.2%, P = 0.001) and 365-day (Tertile 1: 15.2%, Tertile 2: 17.0%, Tertile 3: 19.6%, P = 0.002) death rates across all causes. Cox regression with multiple variables indicates that higher TyG indices were linked to higher all-caused mortality hazard ratios throughout the short and long terms, with a larger predictive value for the former. RCS regression analyses suggested that the risk of death was notably and linearly that is associated with TyG index.
The TyG index is a reliable predictor of all-cause mortality at different stages in critically ill CAD patients, with a higher predictive ability for short-term mortality. Early intervention in patients with elevated TyG index may improve their survival outcomes. Future research should delve into understanding its pathophysiological mechanisms and develop intervention strategies based on the TyG index, providing new insights and strategies to enhance the outlook for critically ill CAD patients.
甘油三酯-葡萄糖（TyG）指数与心血管疾病预后不良有关，是胰岛素抵抗的有效指标。本研究评估了 TyG 指数对所有原因死亡率的短期和长期潜在预测价值，特别是对重症冠状动脉疾病（CAD）患者。
本研究从 MIMIC-IV 数据库的医疗信息市场（Medical Information Marketplace in Intensive Care，MIMIC-IV）数据库中收集了 5452 例重症监护病房 CAD 重症患者的信息。根据 TyG 指数程度，患者被分为三组。临床结局包括短期（30 天）和长期（365 天）全因死亡率。通过受限立方样条（restricted cubic spline，RCS）回归分析和 Cox 比例风险回归检查 TyG 指数与临床结局的相应关系。
TyG 指数升高与 30 天（第 1 三分位：6.1%，第 2 三分位：7.3%，第 3 三分位：9.2%，P=0.001）和 365 天（第 1 三分位：15.2%，第 2 三分位：17.0%，第 3 三分位：19.6%，P=0.002）全因死亡率升高相关。多变量 Cox 回归表明，较高的 TyG 指数与短期和长期的全因死亡率风险比相关，前者的预测价值更大。RCS 回归分析表明，死亡风险与 TyG 指数显著且呈线性相关。
TyG 指数是重症 CAD 患者不同阶段全因死亡率的可靠预测指标，对短期死亡率具有更高的预测能力。对 TyG 指数升高的患者进行早期干预可能会改善其生存结局。未来的研究应深入探讨其病理生理机制，并基于 TyG 指数制定干预策略，为重症 CAD 患者提供新的见解和策略，改善其预后。
