Zeng Xiao, Liu Yuping, Shuai Ping, He Peiyuan, Liu Xiaoli
Outpatient Department, School of Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Department of Health Management Center & Institute of Health Management, School of Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Front Cardiovasc Med. 2025 Apr 9;12:1572709. doi: 10.3389/fcvm.2025.1572709. eCollection 2025.
This study aims to investigate the predictive capability of the triglyceride-glucose index (TyG index) for all-cause mortality among patients with coronary heart disease (CHD), particularly in those with cerebrovascular disease (CVD) and other comorbidities, based on the MIMIC-IV database.
Using the ICD-9/10 coding standards, eligible CHD patients were identified from the MIMIC-IV database (version 3.0) with defined inclusion and exclusion criteria to ensure sample representativeness. Patients were categorized into CVD and other comorbidity groups. Data on mortality rates at 90 days, 1 year, and overall were collected, along with the TyG index and relevant covariates associated with survival risk. Baseline analyses, Spearman correlation, and restricted cubic splines (RCS) were employed to assess the nonlinear relationship between the TyG index and mortality. Kaplan-Meier curves and Cox proportional hazards models were utilized to evaluate survival risk.
A total of 1,872 CHD patients were included, with 578 having CVD and a mortality rate of 50.17%; 1,294 had other comorbidities with a mortality rate of 64.91%. RCS analysis indicated a nonlinear relationship between the TyG index and mortality risk. For patients with concurrent CVD, the lowest mortality risk occurred at a TyG index of 9.37 mmol/L, while for those with other comorbidities, the lowest risk was observed at 9.36 mmol/L. Cox regression analysis revealed a significant association between the TyG index and survival risk in all CHD patients ( = 1.15, 95%: 1.04-1.28, < 0.01). In patients with other comorbidities, an increase in the TyG index was significantly correlated with elevated mortality risk ( = 1.21, 95%: 1.02-1.34, < 0.01).
The TyG index exhibits a nonlinear relationship with mortality risk in CHD patients, with elevated levels significantly increasing mortality risk in those with other comorbidities. These findings suggest that the TyG index may serve as a critical metabolic marker for prognostic evaluation in CHD patients, warranting further clinical attention.
本研究旨在基于MIMIC-IV数据库，探讨甘油三酯-葡萄糖指数（TyG指数）对冠心病（CHD）患者全因死亡率的预测能力，特别是对合并脑血管疾病（CVD）和其他合并症的患者。
采用ICD-9/10编码标准，根据明确的纳入和排除标准，从MIMIC-IV数据库（版本3.0）中识别出符合条件的冠心病患者，以确保样本的代表性。患者被分为CVD组和其他合并症组。收集90天、1年及总体死亡率的数据，以及TyG指数和与生存风险相关的协变量。采用基线分析、Spearman相关性分析和限制性立方样条（RCS）分析来评估TyG指数与死亡率之间的非线性关系。利用Kaplan-Meier曲线和Cox比例风险模型评估生存风险。
共纳入1872例冠心病患者，其中578例合并CVD，死亡率为50.17%；1294例有其他合并症，死亡率为64.91%。RCS分析表明TyG指数与死亡风险之间存在非线性关系。对于合并CVD的患者，TyG指数为9.37 mmol/L时死亡风险最低，而对于有其他合并症的患者，TyG指数为9.36 mmol/L时风险最低。Cox回归分析显示，TyG指数与所有冠心病患者的生存风险显著相关（=1.15，95%置信区间：1.04-1.28，<0.01）。在有其他合并症的患者中，TyG指数升高与死亡风险升高显著相关（=1.21，95%置信区间：1.02-1.34，<0.01）。
TyG指数与冠心病患者的死亡风险呈非线性关系，在有其他合并症患者中，TyG指数升高显著增加死亡风险。这些发现表明，TyG指数可能是冠心病患者预后评估的关键代谢标志物，值得临床进一步关注。
