Yang Xue-Yao, Li Ke, Song Jian-Qiao, Qiao Ke-Xin, Ma Ning, Yang Hao-Chen, Song Xian-Tao, Zuo Hui-Juan
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
New York University, New York, USA.
Sci Rep. 2025 Aug 26;15(1):31490. doi: 10.1038/s41598-025-17315-4.
The triglyceride-glucose (TyG) index is a reliable biomarker for assessing insulin resistance. While previous studies have demonstrated its strong predictive value for cardiovascular disease in the general population, its ability to predict adverse clinical outcomes in patients with coronary heart disease (CHD) remains uncertain. This study aims to explore the association between the TyG index and recurrent myocardial infarction (MI) in young patients with CHD. This retrospective cohort study included 1,013 patients aged 18-44 at the time of initial CHD diagnosis, recruited from the cardiology clinics at Beijing Anzhen Hospital between October 2022 and October 2023. Baseline data and information on recurrent MI were collected from electronic medical records and other medical documents. The TyG index was calculated using the formula: ln [TG (mg/dL) × glucose (mg/dL) / 2]. Multivariable Cox regression, multivariable logistic regression, and restricted cubic spline analyses were used to assess the correlation between the baseline or endpoint TyG index and the likelihood of recurrent MI. The mean baseline TyG index was 9.23 ± 0.71, which decreased to 9.04 ± 0.74 at the follow-up endpoint (P < 0.001). Over an average follow-up period of 2.2 years, 96 (9.5%) cases of recurrent MI were recorded. No significant association was found between the baseline TyG index and recurrent MI in both univariate (HR = 0.99, 95% CI: 0.76-1.32) and multivariate Cox regression analyses (HR = 1.10, 95% CI: 0.82-1.58). However, after adjusting for all influencing factors, the endpoint TyG index was associated with an increased risk of recurrent MI (OR = 1.36, 95% CI: 1.08-1.84). Individuals in the highest tertile of endpoint TyG index showed a higher risk of recurrent MI compared to those in the lowest tertile, with fully adjusted ORs (95% CIs) of 2.12 (1.16-3.86). The TyG index decreased significantly during the follow-up period. An elevated TyG index at the follow-up endpoint is more effective than the baseline measurement in predicting and preventing recurrent MI in young patients with CHD, highlighting its important clinical significance in this population.
甘油三酯-葡萄糖（TyG）指数是评估胰岛素抵抗的可靠生物标志物。虽然先前的研究已证明其在普通人群中对心血管疾病具有很强的预测价值，但其预测冠心病（CHD）患者不良临床结局的能力仍不确定。本研究旨在探讨TyG指数与年轻冠心病患者复发性心肌梗死（MI）之间的关联。这项回顾性队列研究纳入了1013例初次诊断冠心病时年龄在18至44岁之间的患者，这些患者于2022年10月至2023年10月从北京安贞医院心内科门诊招募。从电子病历和其他医疗文件中收集基线数据和复发性心肌梗死的信息。TyG指数使用公式计算：ln[甘油三酯（mg/dL）×葡萄糖（mg/dL）/2]。采用多变量Cox回归、多变量逻辑回归和限制性立方样条分析来评估基线或终点TyG指数与复发性心肌梗死可能性之间的相关性。基线TyG指数的平均值为9.23±0.71，在随访终点降至9.04±0.74（P<0.001）。在平均2.2年的随访期内，记录到96例（9.5%）复发性心肌梗死病例。在单变量（HR=0.99，95%CI：0.76-1.32）和多变量Cox回归分析（HR=1.10，95%CI：0.82-1.58）中，均未发现基线TyG指数与复发性心肌梗死之间存在显著关联。然而，在调整所有影响因素后，终点TyG指数与复发性心肌梗死风险增加相关（OR=1.36，95%CI：1.08-1.84）。与最低三分位数的个体相比，终点TyG指数最高三分位数的个体复发性心肌梗死风险更高，完全调整后的OR（95%CI）为2.12（1.16-3.86）。随访期间TyG指数显著下降。随访终点时TyG指数升高在预测和预防年轻冠心病患者复发性心肌梗死方面比基线测量更有效，突出了其在该人群中的重要临床意义。
