Ma Juan, Wu Peng, Ma Shengzong, Ma Xueping, Jin Ping, Jia Shaobin
School of Clinical Medicine, Ningxia Medical University, Yinchuan, China.
Department of Gynaecology and Obstetrics, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China.
Front Cardiovasc Med. 2024 Sep 12;11:1386318. doi: 10.3389/fcvm.2024.1386318. eCollection 2024.
The relationship between the triglyceride-glucose (TyG) index and no-reflow phenomenon after percutaneous coronary intervention (PCI) in patients with type 2 diabetes mellitus (T2DM) and acute ST-segment elevation myocardial infarction (STEMI) remains unclear. This study aimed to investigate the relationship between baseline TyG index and no-reflow phenomenon in STEMI patients with T2DM after PCI.
This study enrolled 695 patients with T2DM and STEMI from the General Hospital of Ningxia Medical University (2014-2019). Patients were divided into tertiles according to the TyG index levels. The incidence of no-reflow phenomenon was recorded. A multivariate regression model was developed to analyze the association between the baseline TyG index and no-reflow phenomenon. The linear association between the baseline TyG index and no-reflow phenomenon was explored using smooth curve fitting with parallel subgroup analyses. Receiver operating characteristic (ROC) curves were generated to determine the predictive power of the TyG index.
A multivariate logistic regression model revealed that the TyG index was an independent risk factor of no-reflow phenomenon [OR = 3.23, 95%CI: 2.15-4.86, < 0.001], and the occurrence of no-reflow phenomenon increased gradually with the increase of TyG index tertile interval ( < 0.001). Smooth curve fitting showed that the TyG index was linearly related to the risk of no-reflow. Subgroup analysis showed that they participated in this positive correlation. The area under the ROC curve (AUC) of the TyG index for evaluating the occurrence of no-reflow was 0.710 (95% CI: 0.640-0.780; 0.01).
The TyG index is independently associated with no-reflow phenomenon, suggesting that the simple index of the TyG index can be used for risk assessment of no-reflow phenomenon after PCI in STEMI patients with T2DM.
2型糖尿病（T2DM）合并急性ST段抬高型心肌梗死（STEMI）患者经皮冠状动脉介入治疗（PCI）后，甘油三酯-葡萄糖（TyG）指数与无复流现象之间的关系尚不清楚。本研究旨在探讨T2DM合并STEMI患者PCI术后基线TyG指数与无复流现象之间的关系。
本研究纳入了宁夏医科大学总医院695例T2DM合并STEMI患者（2014年至2019年）。根据TyG指数水平将患者分为三分位数。记录无复流现象的发生率。建立多因素回归模型分析基线TyG指数与无复流现象之间的关联。采用平滑曲线拟合和平行亚组分析探讨基线TyG指数与无复流现象之间的线性关联。绘制受试者工作特征（ROC）曲线以确定TyG指数的预测能力。
多因素logistic回归模型显示，TyG指数是无复流现象的独立危险因素[比值比（OR）=3.23，95%置信区间（CI）：2.15 - 4.86，P<0.001]，且无复流现象的发生率随TyG指数三分位数区间的增加而逐渐升高（P<0.001）。平滑曲线拟合显示TyG指数与无复流风险呈线性相关。亚组分析显示各亚组均参与了这种正相关。TyG指数评估无复流发生情况的ROC曲线下面积（AUC）为0. -- 0.780；P<0.01）。
TyG指数与无复流现象独立相关，提示TyG指数这一简单指标可用于T2DM合并STEMI患者PCI术后无复流现象的风险评估。
