Triglyceride-glucose index as a suitable non-insulin-based insulin resistance marker to predict cardiovascular events in patients undergoing complex coronary artery intervention: a large-scale cohort study

• DOI: 10.1186/s12933-023-02110-0
• Publication Date: 2024-01-06T15:03:04Z
• Authors: Jining He; Chenxi Song; Sheng Yuan; Xiaohui Bian; Zhangyu Lin; Min Yang; Kefei Dou
• Keywords: 0302 clinical medicine; Clinical relevance; RC666-701; Research; Diseases of the circulatory (Cardiovascular) system; Insulin resistance; Prognosis; Coronary artery disease; Percutaneous coronary intervention

Abstract Background Insulin resistance (IR), a hallmark of proceeding diabetes and cardiovascular (CV) disease, has been shown to predict prognosis in patients undergoing percutaneous coronary intervention (PCI). The triglyceride-glucose (TyG) index, triglyceride high-density lipoprotein cholesterol (TG/HDL-C) ratio metabolic score for insulin (METS-IR) have be simple reliable non-insulin-based surrogates IR. However, limited studies determined the associations between distinct IR markers CV outcomes complex PCI who are at higher risk events after PCI. Therefore, this study aimed investigate compare prognostic value these Methods This was descriptive cohort study. From January 2017 December 2018, total 9514 Fuwai Hospital were consecutively enrolled 3 indices estimated from included patients. primary endpoint events, defined as composite death, nonfatal myocardial infarction stroke. Results During median follow-up 3.1 years, 324 (3.5%) occurred. Multivariable Cox regression models showed per-unit increase TyG index (hazard [HR], 1.42; 95% confidence interval [CI] 1.13–1.77), rather than elevation either Ln(TG/HDL-C ratio) (HR, 1.18; 95%CI 0.96–1.45) or METS-IR 1.00; 0.98–1.02), associated with increased events. Meanwhile, adding original model led significant improvement C-statistics (0.618 vs. 0.627, P < 0.001), NRI (0.12, = 0.031) IDI (0.14%, 0.003), whereas no improvements observed when Ln (TG/HDL-C (both > 0.05) model. Conclusions not TG/HDL-C METS-IR, positively worse Our study, first time, demonstrated that can serve suitable marker help stratification population.