Abstract
BACKGROUND: With a focus on metabolism-related cardiovascular diseases, the triglyceride-glucose (TyG) index has been used as a surrogate marker of insulin resistance in the prognosis of coronary heart disease. However, the prognostic role of the TyG index in patients with elevated triglycerides, still requires further research. This study aimed to investigate the association between the TyG index and Major Adverse Cardiac and Cerebrovascular Events (MACCE) in patients with hypertriglyceridemia undergoing drug-eluting stent percutaneous coronary intervention (DES-PCI). METHODS: Out of 2250 patients, 813 with hypertriglyceridemia who underwent DES-PCI were retrospectively analyzed. MACCE was regarded as the primary endpoint. Kaplan-Meier (KM) curves were used to evaluate the association between the TyG index and different endpoints. Restricted cubic spline (RCS) analysis was used to examine the relation between the TyG index and MACCE. Subgroup analysis was conducted to further evaluate the interaction between the TyG index and subgroup indicators. RESULTS: Cox regression analysis identified the TyG index as an independent predictor of MACCE (hazard ratio [HR] 1.53, 95% confidence interval [CI] 1.15-2.04, P = 0.004). Receiver operating characteristic (ROC) analysis determined 9.19 as the cutoff value of TyG index. The Kaplan-Meier curve indicated that patients with a TyG index > 9.19 had higher risks of MACCE (HR 2.23, 95% CI 1.35-3.67, P = 0.002), MACE (HR 2.38, 95% CI 1.39-4.09, P = 0.002), unplanned repeat revascularization (HR 2.05, 95% CI 1.02-4.09, P = 0.043) and all-cause death (HR 3.31, 95%CI 1.15-9.47, P = 0.026) than those of patients with a low TyG index. RCS analysis revealed a linear relation between the TyG index and MACCE risk (P for nonlinearity = 0.879, P for overall trend = 0.044). CONCLUSIONS: This study demonstrated that a high TyG index is associated with an increased risk of MACCE, suggesting that the TyG index may serve as a valuable prognostic marker in patients with hypertriglyceridemia undergoing DES-PCI.