Yuan Yujuan, Yu Xiaolin, Tao Jing, Peng Hui, Yang Yining
Department of Cardiology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi, China.
Xinjiang Key Laboratory of Cardiovascular Homeostasis and Regeneration Research, Urumqi, China.
BMJ Open. 2025 Jul 7;15(7):e096869. doi: 10.1136/bmjopen-2024-096869.
To investigate the association between triglyceride-glucose (TyG) index levels at hospital admission and the risk of in-hospital adverse events, including all-cause mortality, in patients with acute myocardial infarction (AMI). The primary hypothesis was that higher TyG index levels are associated with greater risk of adverse in-hospital outcomes.
Retrospective cohort study.
Tertiary hospital inpatient care in China. The study included consecutively hospitalised patients with AMI between 1 August 2011 and 10 January 2022.
A total of 3458 patients with AMI were included. The mean age was 60.8 years, and 78.4% were men. Patients were excluded if they had incomplete data for TyG index calculation or outcome ascertainment.
No therapeutic intervention was assigned; the study was observational. TyG index was calculated using fasting triglycerides and fasting plasma glucose levels at admission.
The primary outcome was all-cause in-hospital mortality. Secondary outcomes included cardiogenic shock and fatal rapid arrhythmia. Outcomes were identified through standardised clinical records.
Among 3458 patients, 375 (10.84%) died during hospitalisation, 236 (6.84%) developed cardiogenic shock and 147 (4.25%) experienced fatal rapid arrhythmia. After multivariable adjustment, higher TyG index levels were significantly associated with increased odds of all-cause mortality (OR, 1.27; 95% CI, 1.02 to 1.57; p<0.05) and cardiogenic shock (OR, 1.54; 95% CI, 1.22 to 1.94; p<0.001). When categorised into quartiles, patients in the highest quartile (Q4) had greater odds of mortality (OR, 1.71; 95% CI, 1.10 to 2.65; p<0.05) and cardiogenic shock (Q2: OR, 2.18; 95% CI, 1.39 to 3.45; Q3: OR, 1.71; 95% CI, 1.06 to 2.77; Q4: OR, 2.81; 95% CI, 1.70 to 4.67; all p<0.05 vs Q1). Restricted cubic spline analysis confirmed a linear association between the TyG index and both primary and secondary outcomes.
Higher TyG index levels at admission are independently associated with an increased risk of all-cause mortality and cardiogenic shock among patients hospitalised for AMI. These findings suggest that the TyG index may serve as a useful prognostic biomarker for risk stratification in this population. Further prospective studies are warranted to validate its clinical utility.
探讨急性心肌梗死（AMI）患者入院时甘油三酯-葡萄糖（TyG）指数水平与院内不良事件风险（包括全因死亡率）之间的关联。主要假设是较高的TyG指数水平与院内不良结局风险增加相关。
回顾性队列研究。
中国三级医院住院治疗。该研究纳入了2011年8月1日至2022年1月10日期间连续住院的AMI患者。
共纳入3458例AMI患者。平均年龄为60.8岁，78.4%为男性。若患者缺乏计算TyG指数或确定结局所需的完整数据，则予以排除。
未分配治疗干预措施；该研究为观察性研究。TyG指数通过入院时的空腹甘油三酯和空腹血糖水平计算得出。
主要结局为全因院内死亡率。次要结局包括心源性休克和致命性快速心律失常。通过标准化临床记录确定结局。
在3458例患者中，375例（10.84%）在住院期间死亡，236例（6.84%）发生心源性休克，147例（4.25%）发生致命性快速心律失常。多变量调整后，较高的TyG指数水平与全因死亡率增加的比值显著相关（比值比[OR]，1.27；95%置信区间[CI]，1.02至1.57；P<0.05）以及心源性休克（OR，1.54；95%CI，1.22至1.94；P<0.001）。当分为四分位数时，最高四分位数（Q4）的患者死亡几率更高（OR，1.71；95%CI，1.10至2.65；P<0.05）以及心源性休克（Q2：OR，2.18；95%CI，1.39至3.45；Q3：OR，1.71；95%CI，1.06至2.77；Q4：OR，2.81；95%CI，1.70至4.67；与Q1相比，所有P<0.05）。受限立方样条分析证实TyG指数与主要和次要结局之间存在线性关联。
AMI住院患者入院时较高的TyG指数水平与全因死亡率和心源性休克风险增加独立相关。这些发现表明TyG指数可能作为该人群风险分层的有用预后生物标志物。有必要进行进一步的前瞻性研究以验证其临床效用。
