甘油三酯-葡萄糖指数在急性心肌梗死女性患者中的重要预测和预后作用：一项回顾性队列研究

Vital Predictive and Prognostic Roles of Triglyceride-Glucose Index in Women With Acute Myocardial Infarction: A Retrospective Cohort Study.

作者信息

Qiu Xiao-Xia, Chen Yong-Li, Wang Xin-Kang, Wang Re-Hua

机构信息

Department of Cardiology Shengli Clinical Medical College of Fujian Medical University Fuzhou China.

South Branch of Cardiology Department Fujian Provincial Hospital Fuzhou China.

出版信息

Health Sci Rep. 2024 Oct 27;7(11):e70157. doi: 10.1002/hsr2.70157. eCollection 2024 Nov.

BACKGROUND AND AIMS

As a biomarker of insulin resistance (IR) in patients with acute myocardial infarction (AMI), the triglyceride-glucose index (TyG index) has received significant attention. However, most research on AMI has focused on male patients, as it is traditionally believed to primarily affect males. Therefore, this study was conducted on a female population with AMI to investigate the potential correlation between the TyG index and their outcomes.

METHODS

A total of 320 women who were admitted to Fujian Provincial Hospital for AMI between January 2017 and December 2019 were included in this study. The TyG index was calculated using the following formula: ln [fasting triglycerides (TG) (mg/dL) × fasting plasma glucose (FPG) (mg/dL)/2]. The primary endpoint of the study was the occurrence of major adverse cardiovascular and cerebrovascular events (MACCEs), which included all-cause mortality, myocardial infarction, repeat revascularization, rehospitalization for heart failure and stroke. The association between the TyG index and unfavorable outcomes in female patients was investigated using the Cox proportional hazards regression model.

RESULTS

It was ultimately estimated that 111 patients developed MACCEs. Females with high TyG indices had a higher prevalence of diabetes, elevated heart rates, and hemoglobin A1c, as well as a higher likelihood of undergoing thrombus aspiration and stent placement. The TyG index was found to be positively correlated with the prevalence of hypertension, diabetes, low-density lipoprotein cholesterol, hemoglobin A1c, and damaged vessels. However, this correlation was modest, yet statistically significant. Furthermore, after adjusting for conventional risk factors, the TyG index (HR: 4.292, 95% CI: 2.784-6.616, < 0.001) was independently associated with MACCEs.

CONCLUSION

As an independent risk predictor, the TyG index has the potential to enhance clinical outcomes for women with AMI.

背景与目的

作为急性心肌梗死（AMI）患者胰岛素抵抗（IR）的生物标志物，甘油三酯-葡萄糖指数（TyG指数）受到了广泛关注。然而，大多数关于AMI的研究都集中在男性患者身上，因为传统上认为AMI主要影响男性。因此，本研究针对女性AMI患者群体进行，以探讨TyG指数与她们预后之间的潜在相关性。

方法

本研究纳入了2017年1月至2019年12月期间因AMI入住福建省立医院的320名女性。TyG指数采用以下公式计算：ln[空腹甘油三酯（TG）（mg/dL）×空腹血糖（FPG）（mg/dL）/2]。该研究的主要终点是主要不良心血管和脑血管事件（MACCE）的发生，包括全因死亡率、心肌梗死、再次血运重建、因心力衰竭再次住院和中风。使用Cox比例风险回归模型研究TyG指数与女性患者不良预后之间的关联。

结果

最终估计有111名患者发生了MACCE。TyG指数高的女性患糖尿病、心率升高、糖化血红蛋白升高的患病率更高，以及进行血栓抽吸和支架置入的可能性更高。发现TyG指数与高血压、糖尿病、低密度脂蛋白胆固醇、糖化血红蛋白和血管受损的患病率呈正相关。然而，这种相关性虽不显著，但具有统计学意义。此外，在调整传统风险因素后，TyG指数（HR：4.292，95%CI：2.784-6.616，P<0.001）与MACCE独立相关。