Liu Huiruo, Wang Liangshan, Wang Hong, Hao Xing, Du Zhongtao, Li Chenglong, Hou Xiaotong
Centre for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, People's Republic of China.
Cardiovasc Diabetol. 2025 Mar 8;24(1):108. doi: 10.1186/s12933-025-02641-8.
The triglyceride-glucose (TyG) index, renowned for its efficacy and convenience in assessing insulin resistance, has been validated as a reliable indicator for various cardiovascular conditions. The current study aims for clarifying the link of TyG with the incidences and prognoses of cardiac arrest (CA) following acute myocardial infarction (AMI).
Our analysis is a multicenter, retrospective study utilizing data from the Medical Information Mart for Intensive Care IV and the eICU Collaborative Research Database. Patients with AMI for whom TyG could be calculated within the first 24 h after admission were included. The main endpoints were in-hospital and ICU mortalities. Correlations between TyG and outcomes were evaluated using logistic regression models, restricted cubic splines (RCS), as well as correlation and linear analyses. Overlap weighting (OW), inverse probability of treatment weighting (IPTW), and propensity score matching (PSM) methodologies were utilized to balance the cohorts, thereby minimizing potential biases. Subgroup analyses were performed in accordance with identified modifiers.
In total, 5208 individuals diagnosed with AMI, among whom 371 developed CA, were ultimately included. Higher TyG levels were observed among AMI populations with CA compared to those without [9.2 (8.7-9.7) vs. 9.0 (8.5-9.4)], and TyG demonstrated a moderate discriminatory capacity for identifying CA occurrences within entire AMI populations. Multivariate logistic regressions revealed TyG serves a significant risk indicator for both in-hospital (OR 1.711) and ICU mortalities (OR 1.520) in AMI-CA patients, and it is also associated with prolonged LOSs. RCS analyses confirmed linear relationships of ascending TyG with increased mortality risks for AMI-CA (P for nonlinearity: 0.592 and 0.816, respectively), which persisted following PSM, OW, and IPTW adjustments. Subgroup analyses further identified a strong link of the TyG with mortality rates among elders, females, individuals with BMI < 28 kg/m, and those with hypertension.
Elevated TyG levels were found to apparently correlate with higher prevalence and adverse outcomes regarding CA in patients with AMI. Our findings point a fresh insight into the significance of the TyG in critically ill coronary conditions.
甘油三酯-葡萄糖（TyG）指数因其在评估胰岛素抵抗方面的有效性和便利性而闻名，已被确认为各种心血管疾病的可靠指标。本研究旨在阐明TyG与急性心肌梗死（AMI）后心脏骤停（CA）的发生率和预后之间的联系。
我们的分析是一项多中心回顾性研究，利用重症监护医学信息数据库IV和电子重症监护病房协作研究数据库的数据。纳入入院后24小时内可计算TyG的AMI患者。主要终点是住院死亡率和重症监护病房死亡率。使用逻辑回归模型、受限立方样条（RCS）以及相关性和线性分析评估TyG与结局之间的相关性。采用重叠加权（OW）、治疗逆概率加权（IPTW）和倾向得分匹配（PSM）方法平衡队列，从而最大限度地减少潜在偏差。根据确定的修饰因素进行亚组分析。
最终纳入5208例诊断为AMI的患者，其中371例发生CA。与未发生CA的AMI患者相比，发生CA的AMI患者TyG水平更高[9.2（8.7-9.7）对9.0（8.5-9.4）]，TyG在识别整个AMI患者群体中CA发生方面具有中等鉴别能力。多因素逻辑回归显示，TyG是AMI-CA患者住院（OR 1.711）和重症监护病房死亡率（OR 1.520）的重要风险指标，并且还与住院时间延长相关。RCS分析证实，TyG升高与AMI-CA患者死亡风险增加呈线性关系（非线性P值分别为0.592和0.816），在PSM、OW和IPTW调整后仍然存在。亚组分析进一步确定TyG与老年人、女性、BMI<28kg/m的个体以及高血压患者的死亡率之间存在密切联系。
发现TyG水平升高与AMI患者CA的较高患病率和不良结局明显相关。我们的研究结果为TyG在重症冠心病中的意义提供了新的见解。
