Abstract
BACKGROUND: The triglyceride‒glucose index (TyG index) is a reliable surrogate for insulin resistance (IR) in individuals with type 2 diabetes mellitus and is associated with cardiovascular disease. Recent studies have reported that H-type hypertension is likewise a predictor of adverse events in patients with coronary heart disease (CHD). However, the relationship between the TyG index and prognosis in patients with H-type hypertension combined with CHD has not yet been reported. In this study, we investigated the relationship between the TyG index and adverse outcomes in patients with H-type hypertension combined with CHD. METHODS: This was a single-center retrospective cohort study that included patients who were diagnosed with H-type hypertension combined with CHD between 2018 and 2023 at Beijing Anzhen Hospital of Capital Medical University. The TyG index was divided into three groups according to tertiles. Kaplan-Meier curves were used to analyze the cumulative risk of major adverse cardiovascular events (MACEs), and ROC curve analysis was performed by the log-rank test. Cox proportional hazards regression models were adopted to explore the relationship between the TyG index and MACEs. C-statistics, NRI, and IDI were used to evaluate the incremental predictive ability of the TyG index. RESULTS: A total of 546 patients were included, with a median follow-up time of 39.00 ± 0.69 months, and 73 MACEs occurred, with higher tertiles of the TyG index associated with a higher cumulative risk of MACEs (log-rank, P = 0.001). After adjusting for confounders, the fully adjusted ORs (95% CI) for T2 and T3 of the TyG index, with the lowest tertile as reference, were 1.64 (0.80-3.36) and 2.43 (1.19-4.97), respectively. The addition of the TyG index led to a significant improvement in the overall predictive power of the baseline model. [C-statistic increased from 0.63 to 0.66, p = 0.031; continuous NRI (95% CI) 0.13 (0.001-0.276), p = 0.038; IDI (95% CI) 0.01 (0.000-0.031), p = 0.047]. CONCLUSION: The TyG index may be an independent risk factor for predicting adverse postoperative cardiovascular events in patients with H-type hypertension combined with CHD, indicating its potential significance in improving risk stratification strategies.