Arrhythmia Center, 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.
Cardiac Arrhythmia Service, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Cardiovasc Diabetol. 2024 Oct 28;23(1):382. doi: 10.1186/s12933-024-02484-9.
The association between the triglyceride-glucose (TyG) index and ventricular arrhythmias (VAs) is unclear. This study aimed to investigate the relationship between the TyG index, VAs, and major cardiovascular events in patients at high risk of sudden cardiac death (SCD).
We enrolled 1046 patients at high risk of SCD with an indication for implantable cardioverter-defibrillator (ICD) implantation at the Chinese National Center for Cardiovascular Diseases. The primary outcome was VAs, defined as sustained ventricular tachycardia and ventricular fibrillation documented by the ICD. The secondary outcomes were cardiac mortality, heart transplantation, and rehospitalization for heart failure.
The mean (± SD) age was 59.6 ± 14.0 years old, and 25.7% were female. During the mean follow-up of 36.1 months, 342 (32.7%) patients had VAs, and 185 (17.7%) patients had major cardiovascular events. The mean fasting glucose and triglyceride levels were 111.9 ± 42.7 mg/dL and 140.0 ± 95.4 mg/L, respectively, with a TyG index range of 6.96-11.8. In the Fine-Gray subdistribution hazard model analysis, an increase in the TyG index was associated with a significant increase in the VAs (per 1 TyG index, hazard ratio [HR] 2.95; 95% confidence interval [CI], 2.29-3.80) and secondary outcome (HR 2.84; 95% CI 1.86-4.34). When stratified into tertiles, the risk of VAs was significantly higher in the highest tertile (HR 4.08; 95% CI, 2.81-5.92) than in the lowest tertile. Analysis of the secondary outcome revealed similar findings (HR 3.18; 95% CI, 1.73-5.85).
In our cohort, the pre-operational TyG index is significantly associated with VAs and major cardiovascular events for patients with high risk of SCD.
甘油三酯-葡萄糖（TyG）指数与室性心律失常（VA）之间的关系尚不清楚。本研究旨在探讨 TyG 指数与高危心源性猝死（SCD）患者的 VA 及主要心血管事件之间的关系。
我们纳入了在中国国家心血管疾病中心因植入式心脏复律除颤器（ICD）植入而有 SCD 风险的 1046 例患者。主要终点为通过 ICD 记录的持续性室性心动过速和心室颤动定义的 VA。次要终点为心脏性死亡、心脏移植和心力衰竭再住院。
平均（±SD）年龄为 59.6±14.0 岁，25.7%为女性。在平均 36.1 个月的随访期间，342（32.7%）例患者发生 VA，185（17.7%）例患者发生主要心血管事件。空腹血糖和甘油三酯的平均水平分别为 111.9±42.7mg/dL 和 140.0±95.4mg/L，TyG 指数范围为 6.96-11.8。在 Fine-Gray 亚分布风险模型分析中，TyG 指数的增加与 VA（每增加 1 TyG 指数，风险比 [HR] 2.95；95%置信区间 [CI] 2.29-3.80）和次要结局（HR 2.84；95%CI 1.86-4.34）显著相关。按三分位分层时，最高三分位 VA 的风险显著高于最低三分位（HR 4.08；95%CI 2.81-5.92）。对次要结局的分析也得出了类似的发现（HR 3.18；95%CI 1.73-5.85）。
在我们的队列中，术前 TyG 指数与高危 SCD 患者的 VA 和主要心血管事件显著相关。
