Association between the triglyceride-glucose index and acute kidney injury in patients undergoing percutaneous coronary: a retrospective analysis of the MIMIC-IV database.

Abstract

Background: Acute kidney injury (AKI) is a common complication that affects the outcomes of patients undergoing percutaneous coronary intervention (PCI). The triglyceride-glucose (TyG) index, a metric computed from fasting blood triglyceride and glucose levels, is closely associated with poor PCI outcomes. This study examined the association between the TyG index and incidence of AKI in patients undergoing PCI.

Methods: Clinical information was obtained from the Medical Information Mart for Intensive Care IV database, which contains clinical data on 70,000 patients admitted to the intensive care unit at Beth Israel Deaconess Medical Center from 2008 to 2019. In total, 435 patients who underwent PCI were enrolled in this retrospective study, and they were categorized according to their AKI status, TyG quartiles, and diabetes mellitus (DM) history to analyze their baseline characteristics. The association of the TyG index with the risk of AKI was assessed using restricted cubic spline regression and logistic regression models. Subgroup analyses were also performed in patients with and without DM.

Results: Compared with the non-AKI population, patients with AKI who underwent PCI had a higher mean TyG index (p = 0.004). The restricted cubic spline regression model revealed a linear correlation between the TyG index and AKI risk (p for nonlinear = 0.123) in patients undergoing PCI. A high TyG index was a risk factor for AKI in non-DM subgroup, as well as in patients with BMI < 28 (odds ratio [OR] = 1.77; p = 0.050) and those with no history of diabetes (OR = 1.83; p = 0.047) or COPD (OR = 1.56; p = 0.030).

Conclusions: This study highlighted the role of the TyG index as a predictive biomarker for AKI in patients without DM undergoing PCI, providing clinicians with a tool for identifying high-risk individuals for early intervention.