甘油三酯指数作为心脏手术后死亡率的预测指标。

Triglyceride index as a predictor of mortality after cardiac surgery.

作者信息

Li Huili, Xiao Fei, Ren Haiqiang, Xu Fei, Che Hao, Zhu Huadong, Zhou Chenghui, Wang Sheng

机构信息

Emergency Department, The State Key Laboratory for Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

出版信息

iScience. 2024 Oct 5;27(11):111107. doi: 10.1016/j.isci.2024.111107. eCollection 2024 Nov 15.

BACKGROUND

The triglyceride-glucose (TyG) index, a marker for insulin resistance, has been linked to adverse cardiac outcomes. Its role in predicting mortality following cardiac surgery remains unclear.

METHODS

This study analyzed 1,810 cardiac surgery patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, categorized by TyG index levels. Mortality was the primary outcome, assessed through Cox proportional hazards regression, time-dependent receiver operating characteristic (ROC) analysis, and restricted cubic splines.

RESULTS

Over a 13-year follow-up, 83 patients died. Higher TyG index levels were associated with increased mortality risk (hazard ratio [HR] = 1.206, 95% confidence interval [CI], 1.121-1.297, < 0.001). Time-dependent ROC analysis showed areas under the curve (AUCs) of 0.914, 0.857, and 0.801 at 1, 3, and 5 years, respectively. The TyG index-based model outperformed established scoring systems in predicting mortality.

CONCLUSIONS

Elevated TyG index levels are significantly associated with higher mortality risk after cardiac surgery, highlighting its potential as a prognostic marker in this population.

背景

甘油三酯-葡萄糖（TyG）指数作为胰岛素抵抗的一个指标，已与不良心脏结局相关联。其在预测心脏手术后死亡率方面的作用仍不明确。

方法

本研究分析了来自重症监护医学信息数据库IV（MIMIC-IV）的1810例心脏手术患者，并根据TyG指数水平进行分类。死亡率是主要结局，通过Cox比例风险回归、时间依赖性受试者工作特征（ROC）分析和限制性立方样条进行评估。

结果

在13年的随访中，83例患者死亡。较高的TyG指数水平与死亡风险增加相关（风险比[HR]=1.206，95%置信区间[CI]，1.121 - 1.297，<0.001）。时间依赖性ROC分析显示，在1年、3年和5年时曲线下面积（AUC）分别为0.914、0.857和0.801。基于TyG指数的模型在预测死亡率方面优于既定的评分系统。