经皮冠状动脉介入治疗的慢性完全闭塞患者中甘油三酯-葡萄糖指数与对比剂肾病的关联

Association between the triglyceride-glucose index and contrast-induced nephropathy in chronic total occlusion patients undergoing percutaneous coronary intervention.

作者信息

Söner Serdar, Aktan Adem, Kılıç Raif, Güzel Hamdullah, Taştan Ercan, Okşul Metin, Cömert Adnan Duha, Coşkun Mehmet Sait, Söner Hülya Tosun, Güzel Tuncay

机构信息

Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, 21070, Turkey.

Department of Cardiology, Mardin Artuklu University, Mardin, Turkey.

出版信息

BMC Cardiovasc Disord. 2025 Jan 20;25(1):31. doi: 10.1186/s12872-025-04474-5.

DOI:10.1186/s12872-025-04474-5

PMID:39828693

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11744983/

Abstract

OBJECTIVE

The triglyceride glucose (TyG) index is a biomarker of insulin resistance and is associated with an increased risk of cardiovascular events. Contrast-induced nephropathy (CIN) is an important complication that causes poor outcomes in patients undergoing percutaneous coronary intervention (PCI). In this study, we aimed to investigate the relationship between the TyG index and CIN and mortality in patients who underwent PCI due to chronic total coronary occlusion (CTO).

METHODS

Two hundred eighteen individuals from three separate medical centers who underwent procedural PCI between February 2010 and April 2012 and had a CTO lesion in at least one coronary artery were recruited. According to the TyG index, patients were divided into two groups. Patients with a TyG index ≥ 8.65 were included in Group 1, and patients with a TyG index < 8.65 were included in Group 2. Patients were followed up for 96 months. The main outcome was the development of CIN and mortality.

RESULTS

The mean age of the patients (65.8 ± 10.94 vs. 61.68 ± 11.4, P = 0.009), diabetes mellitus (60 [44.8%] vs. 11 [13.1%], P < 0.001), and dyslipidemia rates (52 [38.8%] vs. 21 [25%], P = 0.036) were higher in group 1. In multivariable logistic regression analysis, it was seen that age (OR = 1.04, 95% CI = 1.01-1.08, P = 0.020), chronic kidney disease (OR = 2.34, 95% CI = 1.02-5.33, P = 0.044), peripheral artery disease (OR = 5.66, 95% CI = 1.24-25.91, p = 0.026), LVEF (OR = 0.95, 95% CI = 0.92-0.99, P = 0.005), LDL cholesterol levels (OR = 1.00, 95%CI = 1.00-1.02, P = 0.024) and TyG index (OR = 2.17, 95% CI = 1.21-3.89, P = 0.009) were independent predictors of the development of CIN.

CONCLUSION

Our study demonstrates a correlation between the TyG index and the prevalence of CIN in patients with CTO undergoing PCI. Adding the TyG index to the routine clinical evaluation of patients with CTO undergoing PCI may help protect patients from the development of CIN.

摘要

目的

甘油三酯葡萄糖（TyG）指数是胰岛素抵抗的生物标志物，与心血管事件风险增加相关。对比剂肾病（CIN）是经皮冠状动脉介入治疗（PCI）患者预后不良的重要并发症。在本研究中，我们旨在探讨TyG指数与因慢性完全性冠状动脉闭塞（CTO）接受PCI治疗患者的CIN及死亡率之间的关系。

方法

招募了2010年2月至2012年4月期间在三个不同医疗中心接受PCI手术且至少有一条冠状动脉存在CTO病变的218名个体。根据TyG指数，将患者分为两组。TyG指数≥8.65的患者纳入第1组，TyG指数<8.65的患者纳入第2组。对患者进行了96个月的随访。主要结局是CIN的发生和死亡率。

结果

第1组患者的平均年龄（65.8±10.94岁对61.68±11.4岁，P = 0.009）、糖尿病患病率（60例[44.8%]对11例[13.1%]，P < 0.001）和血脂异常率（52例[38.8%]对21例[25%]，P = 0.036）更高。在多变量逻辑回归分析中，发现年龄（OR = 1.04，95%CI = 1.01 - 1.08，P = 0.020）、慢性肾脏病（OR = 2.34，95%CI = 1.02 - 5.33，P = 0.044）、外周动脉疾病（OR = 5.66，95%CI = 1.24 - 25.91，P = 0.026）、左心室射血分数（LVEF）（OR = 0.95，95%CI = 0.92 - 0.99，P = 0.005）、低密度脂蛋白胆固醇水平（OR = 1.00，95%CI = 1.00 - 1.02，P = 0.024）和TyG指数（OR = 2.17，95%CI = 1.21 - 3.89，P = 0.009）是CIN发生的独立预测因素。