Triglyceride-glucose index is associated with silent cerebral infarcts in patients with atrial fibrillation undergoing catheter ablation.

Abstract

Background: Atrial fibrillation catheter ablation (AFCA) is associated with a high risk of silent cerebral infarcts (SCI). Triglyceride-glucose (TyG) index is associated with stroke. However, the relationship between TyG index and SCI is unclear. The aim of this study was to investigate the association of TyG index with SCI after AFCA.

Methods: This was a single-center prospective study. We consecutively selected patients who underwent AFCA from October 2019 to March 2024. All patients completed cranial magnetic resonance imaging (MRI) within 24-48 h after AFCA. SCI was defined as new single or multiple brain injuries detectable on MRI without any clinical manifestations or neurolocalization signs.

Results: A total of 379 patients were enrolled, including 60 patients (15.8%) with SCI. Compared with patients without SCI, patients with SCI had a higher TyG index (9.03 ± 0.87 vs. 8.65 ± 0.56, p < 0.01). Pearson correlation analysis showed that TyG index correlated with left atrium dimension (LAD) (r = 0.119, p = 0.020), neutrophils (r = 0.176, p < 0.001), lymphocytes (r = 0.107, p = 0.037), and skin sympathetic nerve activity (r = 0.304, p = 0.020). After adjusting for potential confounding factors, multivariate analysis showed that TyG index (OR = 2.426; 95%CI: 1.567 ~ 3.757, p < 0.001) was independent factors for SCI after AFCA. Integrating TyG index could significantly improve ability of the model to recognize SCI after AFCA (NRI 0.164, 95% CI 0.069-0.258, p < 0.001; IDI 0.063, 95% CI 0.026-0.100, p < 0.001).

Conclusions: TyG index is associated with SCI after AFCA, and elevated TyG index is an independent risk factor for SCI. Integrating TyG index could significantly improve the risk assessment model regarding SCI.