Triglyceride glucose index in patients with acute coronary syndrome undergoing percutaneous coronary intervention predicts cardiovascular events: a cohort study.

Abstract

Background: Emerging evidence has highlighted the connection between the Triglyceride-glucose (TyG) index and the development and severity of coronary artery disease. However, the role of the TyG index in predicting adverse cardiovascular outcomes among patients who have undergone percutaneous coronary intervention (PCI) remains underexplored.

Methods: Our study encompassed 8019 individuals with acute coronary syndrome (ACS) who had PCI, sourced from the ongoing perspective, observational, single-center COSTIC research. We gathered data on baseline clinical characteristics and the TyG index. The primary endpoints were major adverse cardiovascular events (MACE), which included cardiovascular death, all-cause death, myocardial infarction, and stroke. To examine the relationship between the TyG index and cardiovascular outcomes, we utilized multivariate Cox proportional hazards models and restricted cubic splines.

Results: During the 1-year follow-up period, we documented 341 MACEs, comprising 197 cardiovascular deaths and 242 all-cause deaths. The TyG index was associated with a higher risk of MACE (hazard ratio [HR]: 1.246, 95% confidence interval [CI] 1.064 to 1.459, p = 0.006), cardiovascular death (HR: 1.409, 95% CI 1.150 to 1.727, p = 0.001) and all-cause death (HR: 1.368, 95% CI 1.133 to 1.652, p = 0.001) for each interquartile range (IQR) increment. Stratified analyses unveiled significant interactions between the TyG index and variables such as sex, smoking status, and ACS diagnosis (p for interaction < 0.05). Nevertheless, restricted cubic splines analysis did not detect a non-linear relationship between the TyG index and MACE (p-non-linear = 0.971), cardiovascular mortality (p-non-linear = 0.684), or all-cause mortality (p-non-linear = 0.827).

Conclusions: Our findings underscore a significant association between the TyG index and adverse cardiovascular outcomes, including cardiovascular and all-cause mortality, in ACS patients following PCI. The TyG index may thus function as an early predictor of cardiovascular risk or a potential therapeutic target in the management of cardiovascular disease.