Association between dynamic changes in the triglyceride-glucose index and prognosis in patients with acute ST-segment elevation myocardial infarction.

BACKGROUND

The Triglyceride-Glucose (TyG) index is a surrogate marker of insulin resistance and has been associated with cardiovascular outcomes. However, most studies used single-timepoint measurements, failing to capture its dynamic changes after STEMI.

METHODS

In this retrospective cohort study, 1,092 STEMI patients undergoing PCI were followed for five years. TyG index was measured at baseline and at 3, 6, 9, and 12 months post-discharge. Group-Based Trajectory Modeling (GBTM) was used to identify TyG index trajectories. Cox regression and Kaplan-Meier analysis evaluated their association with major adverse cardiovascular events (MACE).

RESULTS

Three distinct TyG trajectories were identified: persistently high (n = 92), moderate (n = 196), and rapid decline (n = 804). The rapid decline group had significantly lower MACE incidence compared to the persistently high group (P < 0.001). TyG trajectory was an independent predictor of outcomes.

CONCLUSION

Distinct TyG trajectories after STEMI are associated with long-term prognosis. A persistently high TyG trajectory indicates elevated cardiovascular risk, suggesting its potential role in secondary prevention.