Abstract
BACKGROUND: Cardiovascular disease is the leading cause of morbidity and mortality in Indonesia, in which acute myocardial infarction (AMI) has an estimated mortality rate of 9.2%. Heart failure is the most common complication of AMI and increases the risk of death by 3-4 times. The Killip classification assesses the severity and prognosis of acute new-onset heart failure (NOHF) in AMI patients: Class I (6% mortality), Class II (17%), Class III (38%), and Class IV (81%). The triglyceride-glucose (TyG) index, a reliable marker for insulin resistance, is linked to cardiovascular disease pathogenesis. Several studies showed that the TyG index can predict the development of cardiovascular events. AIM: This study aims to determine the correlation between TyG index levels and the severity of acute NOHF complications in patients with acute myocardial infarction based on the Killip classification. METHODS: This cross-sectional analytical observational study involved adult patients with AMI diagnoses in the ER of Dr. Hasan Sadikin Hospital, Bandung, in January-December 2023, who had fasting blood glucose and triglyceride examinations within 72 h of admission and had been assessed with Killip classification. Data analysis was performed using the Spearman test using SPSS software version 25.0. RESULTS: This study included 100 AMI patients who met the inclusion and exclusion criteria. Significant relationships were found between comorbidities (diabetes mellitus, hypertension, and smoking) and patient outcomes against Killip classification. Killip Class I had the most improved outcomes (54 patients). Killip Class IV (10 patients) had the most deaths and highest triglycerides and glucose levels. The TyG index showed a strong positive correlation with acute NOHF severity in patients with AMI based on the Killip classification (r = 0.746, p < 0.001). CONCLUSION: The TyG index has a strong positive correlation with the severity of acute NOHF in patients with acute myocardial infarction based on the Killip classification.