Cardiovascular Diabetology (Aug 2023)

Triglyceride-glucose index in the prediction of adverse cardiovascular events in patients without diabetes mellitus after coronary artery bypass grafting: a multicenter retrospective cohort study

  • Zhenguo Wu,
  • Lin Xie,
  • Dachuan Guo,
  • Sha Chen,
  • Xiaoyu Liu,
  • Xiangfei Sun,
  • Juan Wang,
  • Yerui Zhang,
  • Li Liu,
  • Huiliang Cui,
  • Dejin Zang,
  • Jianmin Yang

DOI
https://doi.org/10.1186/s12933-023-01969-3
Journal volume & issue
Vol. 22, no. 1
pp. 1 – 11

Abstract

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Abstract Background The triglyceride-glucose (TyG) index has been evaluated as a reliable surrogate for insulin resistance (IR) and has been proven to be a predictor of poor outcomes in patients with cardiovascular diseases. However, data are lacking on the relationship of the TyG index with prognosis in nondiabetic patients who underwent coronary artery bypass grafting (CABG). Thus, the purpose of our current study was to investigate the potential value of the TyG index as a prognostic indicator in patients without diabetes mellitus (DM) after CABG. Methods This multicenter, retrospective cohort study involving 830 nondiabetic patients after CABG from 3 tertiary public hospitals from 2014 to 2018. Kaplan–Meier survival curve analysis was conducted followed by the log-rank test. Cox proportional hazards regression models were used to explore the association between the TyG index and major adverse cardiovascular events (MACEs). The incremental predictive power of the TyG index was evaluated with C-statistics, continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Results An incrementally higher TyG index was associated with an increasingly higher cumulative incidence of MACEs (log-rank test, p < 0.001). The hazard ratio (95% CI) of MACEs was 2.22 (1.46–3.38) in tertile 3 of the TyG index and 1.38 (1.18–1.62) per SD increase in the TyG index. The addition of the TyG index yielded a significant improvement in the global performance of the baseline model [C-statistic increased from 0.656 to 0.680, p < 0.001; continuous NRI (95% CI) 0.269 (0.100–0.438), p = 0.002; IDI (95% CI) 0.014 (0.003–0.025), p = 0.014]. Conclusions The TyG index may be an independent factor for predicting adverse cardiovascular events in nondiabetic patients after CABG.

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