Kan Fuqiang, Yang Zewen, Bao Donglai, Tang Mingliang, Ji Ningning
Department of Cardiology, Yiwu Central Hospital, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu, Zhejiang, China.
Front Cardiovasc Med. 2025 Apr 3;12:1476815. doi: 10.3389/fcvm.2025.1476815. eCollection 2025.
The role of the triglyceride-glucose (TyG) index in critically ill patients with congestive heart failure (CHF) and atrial fibrillation (AF), requiring intensive care unit (ICU) admission, remains unclear. This study aimed to investigate the association between the TyG index and the clinical prognosis of critically ill patients with CHF and AF.
This retrospective observational cohort study utilized data from the Medical Information Mart for Intensive Care-IV (MIMIC IV2.2) database. Participants were categorized into four groups based on TyG index level. The primary outcome was hospital all-cause mortality. Multivariable logistic proportional regression analysis and restricted cubic spline regression were employed to assess the TyG index's association with hospital mortality in patients with CHF and AF. Sensitivity analysis included determining the TyG index's feature importance through subgroup analysis in different subgroups.
A total of 787 patients were included in the study, with hospital and ICU mortalities of 14.2% and 8.3%, respectively. Multivariate logistic regression analysis demonstrated that the TyG index was independently associated with an increased risk of hospital mortality (odds ratio (OR), 1.59 [95% confidence interval (CI) 1.15-2.19], = 0.005) and ICU mortality [OR 1.9; (95% CI 1.28-2.83), = 0.001] after adjusting for confounders. The restricted cubic spline regression model indicated a linear increase in the risks of in-hospital and ICU mortality with a higher TyG index. Sensitivity analysis revealed consistent effect sizes and directions in different subgroups, ensuring result stability.
The results of our study suggest a significant association between the TyG index and hospital and ICU all-cause mortality in critically ill patients with CHF and AF. This finding implies that the TyG index could potentially serve as a valuable tool for identifying patients with CHF and AF at an elevated risk of all-cause mortality.
甘油三酯-葡萄糖（TyG）指数在因充血性心力衰竭（CHF）和心房颤动（AF）而需要入住重症监护病房（ICU）的重症患者中的作用仍不明确。本研究旨在探讨TyG指数与CHF和AF重症患者临床预后之间的关联。
这项回顾性观察队列研究使用了重症监护医学信息集市-IV（MIMIC IV2.2）数据库中的数据。参与者根据TyG指数水平分为四组。主要结局是医院全因死亡率。采用多变量逻辑比例回归分析和受限立方样条回归来评估TyG指数与CHF和AF患者医院死亡率之间的关联。敏感性分析包括通过在不同亚组中的亚组分析来确定TyG指数的特征重要性。
本研究共纳入787例患者，医院死亡率和ICU死亡率分别为14.2%和8.3%。多变量逻辑回归分析表明，在调整混杂因素后，TyG指数与医院死亡率增加风险独立相关（比值比（OR），1.59 [95%置信区间（CI）1.15 - 2.19]，P = 0.005）和ICU死亡率[OR 1.9；（95% CI 1.28 - 2.83），P = 0.001]。受限立方样条回归模型表明，随着TyG指数升高，住院和ICU死亡率风险呈线性增加。敏感性分析显示不同亚组中的效应大小和方向一致，确保了结果的稳定性。
我们的研究结果表明，TyG指数与CHF和AF重症患者的医院和ICU全因死亡率之间存在显著关联。这一发现意味着TyG指数可能是识别CHF和AF全因死亡率风险升高患者的有价值工具。
