Abstract
AIMS: 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). METHODS: 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. RESULTS: 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 (P < 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 (P < 0.001). In the subgroup analysis, elevated TyG index levels were consistently associated with an increased risk of MACE across multiple clinical subgroups (P < 0.05). ROC analysis showed that the TyG index significantly predicted the occurrence of MACE (AUC: 0.635, 95% CI: 0.580-0.691, P < 0.001), all-cause death (AUC: 0.565, 95% CI: 0.508-0.622, P = 0.027), non-fatal myocardial infarction (AUC: 0.617, 95% CI: 0.542-0.693, P = 0.004), and unplanned revascularization (AUC: 0.644, 95% CI: 0.578-0.710, P < 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 (P < 0.05). CONCLUSIONS: The TyG index was independently associated with MACE in T2DM patients with AMI combined with HFpEF.