Li Changjiang, Zhao Shun, Li Yingkai, He Songyuan, Jian Wen, Liu Yanci, Cheng Zichao, Peng Hongyu
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Cardiovasc Diabetol. 2025 Jan 29;24(1):45. doi: 10.1186/s12933-024-02555-x.
The triglyceride‒glucose index (TyG index) is a reliable surrogate for insulin resistance (IR) in individuals with type 2 diabetes mellitus and is associated with cardiovascular disease. Recent studies have reported that H-type hypertension is likewise a predictor of adverse events in patients with coronary heart disease (CHD). However, the relationship between the TyG index and prognosis in patients with H-type hypertension combined with CHD has not yet been reported. In this study, we investigated the relationship between the TyG index and adverse outcomes in patients with H-type hypertension combined with CHD.
This was a single-center retrospective cohort study that included patients who were diagnosed with H-type hypertension combined with CHD between 2018 and 2023 at Beijing Anzhen Hospital of Capital Medical University. The TyG index was divided into three groups according to tertiles. Kaplan-Meier curves were used to analyze the cumulative risk of major adverse cardiovascular events (MACEs), and ROC curve analysis was performed by the log-rank test. Cox proportional hazards regression models were adopted to explore the relationship between the TyG index and MACEs. C-statistics, NRI, and IDI were used to evaluate the incremental predictive ability of the TyG index.
A total of 546 patients were included, with a median follow-up time of 39.00 ± 0.69 months, and 73 MACEs occurred, with higher tertiles of the TyG index associated with a higher cumulative risk of MACEs (log-rank, P = 0.001). After adjusting for confounders, the fully adjusted ORs (95% CI) for T2 and T3 of the TyG index, with the lowest tertile as reference, were 1.64 (0.80-3.36) and 2.43 (1.19-4.97), respectively. The addition of the TyG index led to a significant improvement in the overall predictive power of the baseline model. [C-statistic increased from 0.63 to 0.66, p = 0.031; continuous NRI (95% CI) 0.13 (0.001-0.276), p = 0.038; IDI (95% CI) 0.01 (0.000-0.031), p = 0.047].
The TyG index may be an independent risk factor for predicting adverse postoperative cardiovascular events in patients with H-type hypertension combined with CHD, indicating its potential significance in improving risk stratification strategies.
甘油三酯-葡萄糖指数（TyG指数）是2型糖尿病患者胰岛素抵抗（IR）的可靠替代指标，且与心血管疾病相关。近期研究报道，H型高血压同样是冠心病（CHD）患者不良事件的预测指标。然而，TyG指数与H型高血压合并CHD患者预后的关系尚未见报道。在本研究中，我们调查了TyG指数与H型高血压合并CHD患者不良结局之间的关系。
这是一项单中心回顾性队列研究，纳入了2018年至2023年期间在首都医科大学附属北京安贞医院被诊断为H型高血压合并CHD的患者。TyG指数根据三分位数分为三组。采用Kaplan-Meier曲线分析主要不良心血管事件（MACE）的累积风险，并通过对数秩检验进行ROC曲线分析。采用Cox比例风险回归模型探讨TyG指数与MACE之间的关系。使用C统计量、NRI和IDI评估TyG指数的增量预测能力。
共纳入546例患者，中位随访时间为39.00±0.69个月，发生73例MACE，TyG指数三分位数越高，MACE的累积风险越高（对数秩检验，P = 0.001）。在调整混杂因素后，以最低三分位数为参照，TyG指数T2和T3的完全调整后OR（95%CI）分别为1.64（0.80 - 3.36）和2.43（1.19 - 4.97）。加入TyG指数后，基线模型的整体预测能力有显著提高。[C统计量从0.63提高到0.66，p = 0.031；连续NRI（95%CI）0.13（0.001 - 0.276），p = 0.038；IDI（95%CI）0.01（0.000 - 0.031），p = 0.047]。
TyG指数可能是预测H型高血压合并CHD患者术后不良心血管事件的独立危险因素，表明其在改善风险分层策略方面的潜在意义。
