Association between dynamic changes in the triglyceride-glucose index and prognosis in patients with acute ST-segment elevation myocardial infarction.

IF 10.6 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Diabetology Pub Date : 2025-09-01 DOI:10.1186/s12933-025-02858-7

Haiyan Jia, Weifeng Zhang, Shengqi Jia, Xinwei Jia, Shixin Kang

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Abstract

Background: The Triglyceride-Glucose (TyG) index is a surrogate marker of insulin resistance and has been associated with cardiovascular outcomes. However, most studies used single-timepoint measurements, failing to capture its dynamic changes after STEMI.

Methods: In this retrospective cohort study, 1,092 STEMI patients undergoing PCI were followed for five years. TyG index was measured at baseline and at 3, 6, 9, and 12 months post-discharge. Group-Based Trajectory Modeling (GBTM) was used to identify TyG index trajectories. Cox regression and Kaplan-Meier analysis evaluated their association with major adverse cardiovascular events (MACE).

Results: Three distinct TyG trajectories were identified: persistently high (n = 92), moderate (n = 196), and rapid decline (n = 804). The rapid decline group had significantly lower MACE incidence compared to the persistently high group (P < 0.001). TyG trajectory was an independent predictor of outcomes.

Conclusion: Distinct TyG trajectories after STEMI are associated with long-term prognosis. A persistently high TyG trajectory indicates elevated cardiovascular risk, suggesting its potential role in secondary prevention.

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急性st段抬高型心肌梗死患者甘油三酯-葡萄糖指数动态变化与预后的关系

背景：甘油三酯-葡萄糖（TyG）指数是胰岛素抵抗的替代指标，与心血管结局相关。然而，大多数研究采用单时间点测量，未能捕捉STEMI后的动态变化。方法：在这项回顾性队列研究中，对1092例接受PCI治疗的STEMI患者进行了5年的随访。在基线和出院后3、6、9和12个月测量TyG指数。采用基于组的轨迹模型（GBTM）识别TyG指数轨迹。Cox回归和Kaplan-Meier分析评估了它们与主要不良心血管事件（MACE）的相关性。结果：确定了三种不同的TyG轨迹：持续高（n = 92），中等（n = 196）和快速下降（n = 804）。快速下降组的MACE发生率明显低于持续高的组(P结论：STEMI后不同的TyG轨迹与长期预后相关。持续高水平的TyG轨迹表明心血管风险升高，提示其在二级预防中的潜在作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Diabetology 医学-内分泌学与代谢

CiteScore

12.30

自引率

15.10%

发文量

240

审稿时长

1 months

期刊介绍： Cardiovascular Diabetology is a journal that welcomes manuscripts exploring various aspects of the relationship between diabetes, cardiovascular health, and the metabolic syndrome. We invite submissions related to clinical studies, genetic investigations, experimental research, pharmacological studies, epidemiological analyses, and molecular biology research in this field.