Triglyceride-glucose index as a predictor of contrast-induced nephropathy in nondiabetic patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention: a retrospective study.

Abstract

Background: Contrast-induced nephropathy (CIN) is a significant complication following percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) patients. This study aimed to evaluate the association between the triglyceride-glucose (TyG) index and CIN development in nondiabetic patients with STEMI undergoing PCI.

Methods: This retrospective study included 1625 nondiabetic patients with STEMI treated with PCI within 12 h of symptom onset. CIN was defined as an increase in serum creatinine of greater than 25% or greater than or equal to 0.5 mg/dl from baseline within 48-72 h postprocedure. Patients were stratified into quartiles based on TyG index levels. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to identify independent predictors of CIN and determine the optimal TyG index cutoff.

Results: Among the 1625 patients, 14% developed CIN. Patients in the highest TyG quartile (Q4) exhibited the highest incidence of CIN (27%, P  < 0.01). The TyG index was independently associated with CIN [odds ratio (OR): 2.054, 95% confidence interval (CI): 1.564-2.697, P  < 0.001] alongside baseline creatinine (OR: 1.666, 95% CI: 1.053-2.635, P  = 0.001) and contrast volume (OR: 1.003, 95% CI: 1.002-1.005, P  = 0.005). ROC analysis yielded a TyG index cutoff value of 9.11 (AUC: 0.722) with 70% sensitivity and 62% specificity.

Conclusion: The TyG index is a reliable marker for predicting CIN in nondiabetic patients with STEMI undergoing PCI. Its independent association with CIN, combined with its cost-effectiveness, highlights its potential for improving risk stratification in this high-risk group.