Abstract
BACKGROUND: Acute coronary syndrome (ACS) is one of the leading causes of death, but there is no attention paid to the risk stratification of patients with ACS. AIMS: We evaluated the utility of the triglyceride-glucose (TyG) index in predicting the hospital and intensive care unit (ICU) mortality of critically ill patients with ACS. MATERIALS AND METHODS: The study patients were collected from the eICU Collaborative Research Database. TyG index was calculated as the ln (fasting glucose level [mg/dL] × triglyceride level [mg/dL]/2). The endpoints were hospital and ICU mortality. The univariate and multivariate logistic regressions and subgroup analysis were used to determine the relationship between the TyG index and two endpoints. The scatter plots, bar graphs and smoothing curves further proved it. RESULTS: 5237 critically ill patients with ACS were enrolled. The TyG index was obviously higher in nonsurvivors groups than survivors groups. TyG index was significantly associated with hospital mortality in univariate analysis (odds ratio [OR] 1.33, 95% confidence interval [CI] 1.15-1.53, P < 0.001), adjusted model I (OR 1.59, 95% CI 1.36-1.85, P < 0.001) and adjusted model II (OR 2.23, 95% CI 1.50-3.31, P < 0.001). The ICU mortality showed the same trends (OR 1.50, 95% CI 1.26-1.78, OR 1.73, 95% CI 1.45-2.06, OR 2.53, 95% CI 1.59-4.03, P < 0.001). The same trends were observed after stratified by tertiles and quartiles. There were continuous linear relations between the TyG index and hospital and ICU mortality. CONCLUSION: TyG index is an independent predictor of ICU and hospital mortality in critically ill patients with ACS.