Influence of triglyceride-glucose index on long-term prognosis after percutaneous coronary intervention in patients with acute myocardial infarction

Abstract:

Objective To evaluate the predictive role of triglyceride-glucose index（TyG index） in long-term major adverse cardiovascular events（MACE） in patients with acute myocardial infarction（AMI） undergoing percutaneous coronary intervention.Methods Patients with AMI undergoing percutaneous coronary intervention who were admitted to Beijing Shijingshan Hospital from December 2012 to October 2018 were retrospectively analyzed. The formula for TyG index was： ln［fasting triglyceride（mg/dL） × fasting blood glucose（mg/dL）/2］. Patients were divided into three groups based on TyG index tertiles，and their clinical and laboratory data and MACE （including all-cause death，non-fatal myocardial infarction， or re-vascularization） were recorded. Cox risk regression analysis was used for univariate and multivariate analysis.Results The median follow-up time was 31（21-41） months，45 cases（9.3%） died and 91 cases（24.2%） had MACE. With the increase of TyG index， the incidence of MACE significantly increased（P=0.027）. Patients with MACE were older， and had higher levels of TyG index，fasting blood glucose，glycated hemoglobin（HbA1c） and uric acid. In addition，older patients had a higher proportion of previous diabetes，cerebrovascular history，Killip grade > 1 and three-vessel lesions. TyG index was an independent predictor of long-term （more than 1 year） mortality after adjustment for other confounders in multivariate Cox regression analysis（HR=1.656；95%CI=1.226-2.237；P=0.001）. Kaplan-Meier analysis showed that patients with high TyG index had the lowest survival rate of MACE（P=0.011）.Conclusion TyG index is an independent predictor of long-term MACE in AMI patients undergoing percutaneous coronary intervention.