Zhang Xiaodong, Niu Nan, Yu Shengqin, Zhang Xinxin, Chen Xuefu, Yu Ming, Zhang Wenmiao, Liu Ying, Wang Zhenwei
Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China.
Front Endocrinol (Lausanne). 2025 Aug 26;16:1585067. doi: 10.3389/fendo.2025.1585067. eCollection 2025.
This study was conducted to evaluate the correlation between triglyceride-glucose index (TyG) and major adverse cardiovascular events (MACE) in patients with type 2 diabetes mellitus (T2DM) and heart failure with preserved ejection fraction (HFpEF) after acute myocardial infarction (AMI).
This retrospective study at the First Affiliated Hospital of Dalian Medical University included 400 AMI patients with T2DM and HFpEF who underwent percutaneous coronary intervention (PCI) between 1 January 2018 and 1 January 2023. The study was conducted using univariate and multivariate Cox regression analyses, subgroup analyses, receiver operating characteristic (ROC) curves, and Kaplan-Meier survival curves to assess the correlation between the TyG index and MACE.
Multivariate Cox regression analyses showed that in model 3 with variables fully adjusted, when TyG was used as a categorical variable, the risk of MACE in the TyG T2 and T3 groups was 1.622 times and 2.247 times higher than that in the T1 group, respectively ( < 0.05). When TyG was used as a continuous variable, the risk of MACE increased by 49.5% for every 1 unit increase in the TyG index ( < 0.001). In the subgroup analysis, elevated TyG index levels were consistently associated with an increased risk of MACE across multiple clinical subgroups ( < 0.05). ROC analysis showed that the TyG index significantly predicted the occurrence of MACE (AUC: 0.635, 95% CI: 0.580-0.691, < 0.001), all-cause death (AUC: 0.565, 95% CI: 0.508-0.622, = 0.027), non-fatal myocardial infarction (AUC: 0.617, 95% CI: 0.542-0.693, = 0.004), and unplanned revascularization (AUC: 0.644, 95% CI: 0.578-0.710, < 0.001). The Kaplan-Meier survival curves revealed statistically significant differences in survival probabilities for the occurrence of MACE, all-cause death, non-fatal myocardial infarction, and unplanned revascularization across the three TyG index groups as the follow-up period progressed ( < 0.05).
The TyG index was independently associated with MACE in T2DM patients with AMI combined with HFpEF.
本研究旨在评估2型糖尿病（T2DM）合并急性心肌梗死（AMI）后射血分数保留的心力衰竭（HFpEF）患者的甘油三酯-葡萄糖指数（TyG）与主要不良心血管事件（MACE）之间的相关性。
大连医科大学附属第一医院的这项回顾性研究纳入了2018年1月1日至2023年1月1日期间接受经皮冠状动脉介入治疗（PCI）的400例合并T2DM和HFpEF的AMI患者。采用单因素和多因素Cox回归分析、亚组分析、受试者工作特征（ROC）曲线和Kaplan-Meier生存曲线来评估TyG指数与MACE之间的相关性。
多因素Cox回归分析显示，在变量完全调整的模型3中，当TyG作为分类变量时，TyG T2组和T3组发生MACE的风险分别比T1组高1.622倍和2.247倍（<0.05）。当TyG作为连续变量时，TyG指数每增加1个单位，MACE的风险增加49.5%（<0.001）。在亚组分析中，TyG指数升高在多个临床亚组中均与MACE风险增加相关（<0.05）。ROC分析显示，TyG指数显著预测MACE的发生（AUC：0.635，95%CI：0.580-0.691，<0.001）、全因死亡（AUC：0.565，95%CI：0.508-0.622，=0.027）、非致命性心肌梗死（AUC：0.617，95%CI：0.542-0.693，=0.004）和计划外血管重建（AUC：0.644，95%CI：0.578-0.710，<0.001）。Kaplan-Meier生存曲线显示，随着随访期的进展，在三个TyG指数组中，MACE、全因死亡、非致命性心肌梗死和计划外血管重建发生的生存概率存在统计学显著差异（<0.05）。
TyG指数与合并AMI和HFpEF的T2DM患者的MACE独立相关。
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