Triglyceride-glucose index as a marker of adverse cardiovascular prognosis in patients with coronary heart disease and hypertension

The predictive significance of the triglyceride-glucose index in forecasting adverse cardiovascular events among type 2 diabetes mellitus patients with co-existing hyperuricemia: a retrospective cohort study

BACKGROUND

The triglyceride-glucose (TyG) index serves as a crucial indicator for evaluating insulin resistance (IR) and cardiovascular risk among patients with type 2 diabetes mellitus (T2DM). Concurrently, hyperuricemia (HUA) strongly correlates with adverse cardiovascular outcomes. However, the prognostic value of the TyG index, particularly in patients exhibiting both conditions, remains inadequately defined. This study assessed the association between TyG index measurements and the incidence of major adverse cardiovascular events (MACEs) among patients simultaneously diagnosed with T2DM and HUA.

METHODS

This retrospective, single-center cohort study included 628 patients diagnosed with both T2DM and HUA at the Chaohu Hospital (Anhui Medical University) between 2019 and 2024. Participants were stratified into tertiles based on their TyG index values. Kaplan-Meier survival curves with log-rank tests estimated the risk of MACEs, and Cox regression analyses calculated hazard ratios. The additional predictive contribution of the TyG index was evaluated using C statistics, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) metrics.

RESULTS

During the 38.00 ± 8.78 months follow-up period, 74 MACEs were recorded. A significant proportional relationship emerged between the TyG index and cardiovascular events-patients in the highest tertile demonstrated markedly increased risk compared with those in the lowest tertile (HR = 2.45, 95% CI 1.23-4.95). A pivotal threshold was identified at TyG > 8.40, beyond which each standard deviation increase corresponded to a 66% higher probability of MACEs (HR = 1.66, 95% CI 1.36-2.36, P = 0.014). Integrating the TyG index into traditional risk models significantly improved predictive performance (C statistic increase: 0.64 → 0.67, P = 0.029; NRI = 0.14, IDI = 0.02, both P < 0.05).

CONCLUSION

The TyG index constitutes an autonomous MACE predictor specifically within the distinctive cohort of patients manifesting both T2DM and HUA. This study is the first to validate the TyG > 8.40 threshold in T2DM patients with HUA and identify a synergistic interaction between serum uric acid (SUA) and TyG, providing a novel stratification tool for managing dual metabolic disorders.

Evaluation and comparison of inflammatory and insulin resistance indicators on recurrent cardiovascular events in patients undergoing percutaneous coronary intervention: a single center retrospective observational study

BACKGROUND

The aim of this study was to evaluate and compare the usefulness of the C-reactive protein (CRP)-triglyceride glucose (TyG) index (CTI) and other insulin resistance (IR) or inflammatory indexes for predicting recurrent cardiovascular events in percutaneous coronary intervention (PCI)-treated patients. In addition, the mediating effects of systemic inflammation, represented by high-sensitive CRP (hs-CRP), on TyG index-associated adverse cardiovascular events across different subgroups were also evaluated.

METHODS

The formula for calculating the CTI was 0.412 × ln [high-sensitivity CRP (mg/L)] + ln [triglyceride (mg/dl) × fasting glucose (mg/dl)/2]. The primary endpoint was defined as the incidence of major adverse cerebrovascular and cardiovascular events (MACCEs), including cardiovascular death, nonfatal acute myocardial infarction (AMI), nonfatal ischemic stroke and repeat coronary revascularization.

RESULTS

Among the 2383 PCI-treated patients, 413 experienced MACCEs during a median of 34 months follow-up. Correlation analysis showed CTI was significantly associated with cardiometabolic factors. The CTI was the strongest predictor for MACCEs (adjusted HR 1.85, 95% CI 1.44-2.38) among the inflammatory and IR indicators. CTI had an incremental effect on the predictive ability of the prognostic model for MACCEs (NRI: 0.220, p < 0.001; IDI: 0.009, p < 0.001). Subgroup analysis revealed that the prognostic value of the CTI remained significant across all subgroups (all p < 0.05) whereas the predictive abilities of other IR or inflammatory indicators were more or less influenced by the metabolic abnormalities. Finally, mediation analysis revealed that the effects of systemic inflammation on TyG index-associated MACCEs were more prominent in patients with metabolic disorders.

CONCLUSIONS

CTI was a practical indicator for evaluating cardiometabolic diseases. Among the IR and inflammatory indicators, CTI was the most promising index for predicting recurrent cardiovascular risks in PCI-treated patients. TyG index-associated cardiovascular risks were partially mediated by systemic inflammation in patients with metabolic abnormalities.

Interaction between obesity and asthma in children and adolescents with hypertension based on NHANES 2007-2020

Objectives

This study aims to elucidate the relationship between obesity and asthma in children and adolescents with hypertension based on the 2007-2020 National Health and Nutrition Examination Survey (NHANES).

Methods

Weighted logistic regression models assessed obesity and asthma's effects on hypertension risk, reported as odds ratio (OR) and 95% confidence interval (CI).

Results

A cross-sectional analysis of 10,838 NHANES individuals aged 8-17 found 630 (5.8%) had hypertension, with significant differences in age, sex, poverty-to-income ratio, low birth weight, presence or absence of obesity and asthma, triglyceride concentration, fasting glucose concentration, and tobacco exposure compared to those without hypertension (p < .05). After adjusting for all covariates, children and adolescents with obesity or asthma had a higher risk of hypertension (obesity: adjusted OR 2.14, 95% CI 1.7-2.7; asthma: adjusted OR 1.43, 95% CI 1.1-1.9). Individuals with both obesity and asthma showed a significantly higher risk of hypertension compared to those without these conditions (adjusted OR 2.87, 95% CI 1.9-4.4) (p < .001). The synergistic effect of childhood obesity and asthma on hypertension risk remained robust after the stratified subgroup analysis based on age, sex, birth weight, and tobacco exposure.

Conclusion

This study demonstrates that obesity and asthma exert a synergistic effect on childhood hypertension, emphasizing the need for comprehensive interventions targeting weight management and asthma control. There is a pressing need for future research to delve deeper into the mechanisms underlying the interactions between childhood asthma, obesity, and hypertension.

Nonlinear relationship between triglyceride-glucose index and cardiovascular mortality with competing risk analysis on populations aged 18-80 years

BACKGROUND

The existing evidence regarding the relationship between the triglyceride-glucose index (TyG index) and cardiovascular mortality risk remains relatively limited and controversial, particularly within the context of competing risk scenarios. This study seeks to investigate this relationship, while further incorporating the impact of non-cardiovascular mortality as a competing risk event to this association.

METHODS

Data of eligible participants were extracted from National Health and Nutrition Examination Surveys (NHANES) 1999-2018. Traditional Cox proportional hazards regression and Fine-Gray sub-distribution hazard models were applied to assess the TyG index and cardiovascular mortality relationship. Restricted cubic splines were used to estimate possible non-linearity, while segmented regression and log-likelihood ratio tests were used to identify threshold values and model fit.

RESULTS

The final analysis compromised a number of 23,800 participants, with a mean age of 47.75 ± 18.06 years, and female prominent (51.72%). After fully adjusted, it revealed a positive relationship between the TyG index and cardiovascular mortality risk (HR = 1.24, 95%CI 1.08-1.41, P = 0.0017). Furthermore, upon considering non-cardiovascular mortality as competing risk event, the result of Fine-Gray sub-distribution hazard model analysis attenuated but remained significantly positive (sHR = 1.11, 95%CI 1.11-1.11, P < 0.0001). Besides, a non-linear reversed L-shaped relationship was revealed, with a cutoff value determined as 9.4. Below 9.4, the relationship was insignificant (HR = 1.10, 95%CI 0.92-1.31, P = 0.2866), whereas beyond 9.4, the relationship became positive (HR = 1.64, 95%CI 1.21, 2.22, P = 0.0014), and the log-likelihood ratio test confirmed the threshold effect (P = 0.049). Significant interaction was observed in age and body mass index (BMI) subgroups, respectively, with individuals ≤ 65 years and normal BMI category exhibited higher risk in the relationship (P for interaction < 0.05).

CONCLUSIONS

The present study reveals a robust positive relationship between the TyG index and cardiovascular mortality among individuals aged 18-80 years despite the influence from non-cardiovascular mortality event. Additionally, the relationship was non-linear with the risk intensifying when TyG index beyond a specific threshold. Besides, individuals younger than 65 years old with normal BMI may be more susceptible in this relationship.

CLINICAL TRIAL NUMBER

Not applicable.

Mediating role of triglyceride glucose-related index in the associations of composite dietary antioxidant index with cardiovascular disease and mortality in older adults with hypertension: a national cohort study

Background

This research investigates the relationships between the composite dietary antioxidant index (CDAI) and the likelihood of cardiovascular disease (CVD) and mortality in older adults with hypertension. Utilized data from the National Health and Nutrition Examination Survey (NHANES) to investigate the potential mediating role of the triglyceride-glucose (TyG) index in these relationships.

Methods

A cohort of 5,276 participants, aged 65 years or older and diagnosed with hypertension, was extracted from the NHANES database. The main outcomes examined were the odds of CVD and mortality, utilizing data from the National Center for Health Statistics (NCHS). Multivariate logistic regression models were utilized to evaluate the relationship between CDAI and CVD. Cox proportional hazards regression models and Kaplan-Meier survival curves were utilized to analyze the relationship between CDAI and mortality. Mediation analysis was conducted to assess the potential intermediary role of TyG-related indicators-specifically TyG, TyG-BMI, TyG-WC, and TyG-WHtR- in the connection between CDAI and mortality.

Results

The mean CDAI for the study participants was 1.88 ± 3.90, and the average age was 74.15 ± 5.96 years. During an average follow-up duration of 109.51 months, 4,712 cases of CVD and 725 recorded deaths were observed. In the fully adjusted models, CDAI showed a negative association with both CVD (Odds Ratio [OR] = 0.94, 95% Confidence Interval [CI] = 0.92-0.97) and mortality (Hazard Ratio [HR] = 0.95, 95% CI = 0.93-0.97). Mediation analysis indicated that the TyG-BMI, TyG-WC, and TyG-WHtR indices accounted for 33.1%, 34.3%, and 19.1% of the relationship between CDAI and mortality, respectively.

Conclusion

A higher CDAI demonstrated an inverse association with both CVD and mortality in elderly hypertensive individuals. The relationship was partially mediated by TyG-related indices, indicating that increased antioxidant intake may lead to improved health outcomes and a decreased risk of poor prognosis in this population.

The relationship between the triglyceride-glucose (TyG) index and all-cause mortality in ICU patients with primary hypertension: a retrospective study

Primary hypertension is the most common type of hypertension, with a complex and not fully understood pathogenesis. Insulin resistance (IR) is a metabolic abnormality that has been shown to be quite prevalent among patients with hypertension in existing literature. The triglyceride-glucose (TyG) index is a reliable indicator for assessing insulin resistance (IR). This study aims to evaluate the relationship between the TyG index at admission and all-cause mortality (ACM) in patients with severe primary hypertension, and to explore its role in predicting the future all-cause mortality risk in primary hypertension patients. This study employs a retrospective design to categorize all patients into four quartiles based on the TyG index. The Kaplan-Meier (K-M) method was utilized to estimate the survival curves for each group and to compare the survival outcomes across different quartiles. To assess the nonlinear relationship between the TyG index and prognosis, Cox proportional hazards regression models and restricted cubic splines (RCS) were applied, adjusting for potential confounders. Additionally, subgroup analyses were performed to conduct stratified analyses and interaction tests. Kaplan-Meier survival curve analysis showed that patients with higher TyG index levels had higher all-cause mortality rates at 30 days, 60 days, and 90 days post-admission. This indicates that a higher TyG index is associated with an increased risk of death in the short term. Additionally, multivariate Cox proportional hazards regression analysis revealed that an increased TyG index was significantly associated with all-cause mortality at 30 days, 60 days, and 90 days. Meanwhile, RCS analysis indicates that as the TyG index level increases, the hazard ratio (HR) shows a significant upward trend, suggesting a gradual increase in the risk of all-cause mortality. In summary, among patients with primary hypertension in the intensive care unit, elevated TyG levels are associated with an increased risk of short-term mortality.

Association between C-reactive protein-triglyceride glucose index and stroke risk in different glycemic status: insights from the China Health and Retirement Longitudinal Study (CHARLS)

OBJECTIVE

C-reactive protein-triglyceride-glucose index (CTI) has been proposed as a novel biomarker for insulin resistance and inflammation. However, the association between CTI and the risk of stroke, particularly in individuals with different glycemic status, remains unclear.

METHODS

A total of 10,443 middle-aged and elderly participants were enrolled from the China Health and Retirement Longitudinal Study (CHARLS). The primary endpoint was the occurrence of stroke events. The CTI was calculated using the formula 0.412* Ln (CRP [mg/L]) + Ln (TG [mg/dl] × FPG [mg/dl])/2. The Kaplan-Meier curves, Cox proportional hazard models, and restricted cubic spline analysis were applied to explore the association between CTI and the risk of stroke according to gender, age and glycemic status.

RESULTS

During a median follow-up of 9 years, 960 (9.2%) participants experienced a stroke. Our findings revealed a significant positive linear relationship between CTI and the occurrence of stroke. The association was similar between male and female, despite the HR tended to be higher in females (HR 1.22, 95% CI 1.09, 1.36) than males (HR 1.15, 95% CI 1.02, 1.29), and similar in middle-aged (HR 1.25, 95% CI 1.11, 1.41) and elderly participants (HR 1.12, 95% CI 1.00, 1.26). In different glycemic status, high levels of CTI were found to be linked to an increased risk of stroke in individuals with normal glucose regulation (NGR) (HR 1.33, 95% CI 1.11, 1.59) and prediabetes mellitus (Pre-DM) (HR 1.20, 95% CI 1.04, 1.39). However, this association was not observed in individuals with diabetes mellitus (DM).

CONCLUSIONS

Our findings revealed a significant positive linear relationship between CTI and the occurrence of stroke. The association between CTI and stroke was similar between male and female, and similar in middle-aged and elderly participants. In different glycemic status, the association was significant in individuals with NGR and Pre-DM.

Prognostic Value of the Triglyceride-Glucose Index Combined with Non-HDL-C/HDL-C Ratio for Predicting Coronary Microvascular Dysfunction in ACS Patients Post-PCI

Background

Coronary microvascular dysfunction (CMD) after percutaneous coronary intervention (PCI) is a critical prognostic factor in acute coronary syndrome (ACS). This study aimed to evaluate the combined predictive value of the triglyceride-glucose index (TyG) and non-HDL-C/HDL-C ratio (NHHR) for CMD in ACS patients post-PCI.

Methods

A retrospective analysis of 542 ACS patients undergoing PCI (2021-2023) was conducted. Patients were classified into CMD (n=273) and non-CMD (n=269) groups based on CMD presence post-PCI. Baseline characteristics and biochemical markers were analyzed. TyG index and NHHR were calculated, and univariate and multivariate analyses were performed to identify predictors of CMD. ROC curves evaluated the predictive value of TyG combined with NHHR, while net reclassification index (NRI) and integrated discrimination improvement (IDI) assessed incremental predictive value.

Results

CMD patients exhibited significantly higher levels of TyG and NHHR compared to non-CMD patients. Multivariate logistic regression indicated that TyG (OR = 1.89, 95% CI: 1.24-2.88, P = 0.003) and NHHR (OR = 1.34, 95% CI: 1.11-1.62, P = 0.011) were independent predictors of CMD. The combined model showed significant improvement in discrimination (C-statistic increased from 0.750 to 0.782, P < 0.001) and reclassification (NRI = 0.458, IDI = 0.051, both P < 0.001).

Conclusion

TyG and NHHR are novel predictors of CMD post-PCI, with combined use improving risk stratification. Given the retrospective nature of the study, further multicenter prospective research is required to validate these findings.

Is the triglyceride-glucose index ready for cardiovascular risk assessment?

AIMS

Insulin resistance is a major risk factor for cardiovascular disease. Thus, early identification of insulin resistance is important for classifying individuals at high cardiovascular risk. All the tools commonly used in epidemiological studies and clinical practice to assess insulin resistance require measuring insulin levels, which is a limitation. Hence, simpler methods have been proposed to overcome these limitations. One of the most promising is the triglyceride-glucose index. Therefore, this narrative review focuses on the most significant epidemiological findings concerning the relationship between the triglyceride-glucose index and cardiovascular risk. Furthermore, it also highlights this new tool's strengths, limitations, and perspectives for assessing cardiovascular risk.

DATA SYNTHESIS

Even though the assessment of this index is relatively recent, there are numerous papers on this topic, and their number is constantly increasing. Observational studies have shown a substantial positive association between the triglyceride-glucose index and cardiovascular risk, although some conflicting results have been observed.

CONCLUSIONS

The index is strongly associated with cardiovascular mortality and cardiovascular risk factors. However, some gaps need to be addressed.

Triglyceride-glucose index predicts adverse cardiovascular events in patients with H-type hypertension combined with coronary heart disease: a retrospective cohort study

BACKGROUND

The triglyceride‒glucose index (TyG index) is a reliable surrogate for insulin resistance (IR) in individuals with type 2 diabetes mellitus and is associated with cardiovascular disease. Recent studies have reported that H-type hypertension is likewise a predictor of adverse events in patients with coronary heart disease (CHD). However, the relationship between the TyG index and prognosis in patients with H-type hypertension combined with CHD has not yet been reported. In this study, we investigated the relationship between the TyG index and adverse outcomes in patients with H-type hypertension combined with CHD.

METHODS

This was a single-center retrospective cohort study that included patients who were diagnosed with H-type hypertension combined with CHD between 2018 and 2023 at Beijing Anzhen Hospital of Capital Medical University. The TyG index was divided into three groups according to tertiles. Kaplan-Meier curves were used to analyze the cumulative risk of major adverse cardiovascular events (MACEs), and ROC curve analysis was performed by the log-rank test. Cox proportional hazards regression models were adopted to explore the relationship between the TyG index and MACEs. C-statistics, NRI, and IDI were used to evaluate the incremental predictive ability of the TyG index.

RESULTS

A total of 546 patients were included, with a median follow-up time of 39.00 ± 0.69 months, and 73 MACEs occurred, with higher tertiles of the TyG index associated with a higher cumulative risk of MACEs (log-rank, P = 0.001). After adjusting for confounders, the fully adjusted ORs (95% CI) for T2 and T3 of the TyG index, with the lowest tertile as reference, were 1.64 (0.80-3.36) and 2.43 (1.19-4.97), respectively. The addition of the TyG index led to a significant improvement in the overall predictive power of the baseline model. [C-statistic increased from 0.63 to 0.66, p = 0.031; continuous NRI (95% CI) 0.13 (0.001-0.276), p = 0.038; IDI (95% CI) 0.01 (0.000-0.031), p = 0.047].

CONCLUSION

The TyG index may be an independent risk factor for predicting adverse postoperative cardiovascular events in patients with H-type hypertension combined with CHD, indicating its potential significance in improving risk stratification strategies.

Global trends in the burden of ischemic heart disease based on the global burden of disease study 2021: the role of metabolic risk factors

BACKGROUND

Ischemic heart disease (IHD) remains a leading cause of mortality and morbidity globally. This study aims to evaluate the trends in IHD burden across different socioeconomic regions using data from the Global Burden of Disease Study 2021 (GBD 2021) and to understand the impact of the metabolic risk factors on these trends.

METHODS

Data from GBD 2021 was analyzed to evaluate the global age-standardized death rates (ASDR) and disability-adjusted life years (ASRDALYs) linked to IHD. Key metabolic risk factors evaluated included high systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDLc), fasting plasma glucose (FPG), and body mass index (BMI). Temporal trends were assessed using estimated annual percentage changes (EAPCs), with further analysis by age, sex and socio-demographic index (SDI).

RESULTS

Resource-abundant regions showed notable reductions in ASDR and ASRDALYs, largely due to effective management of SBP and LDLc, resulting in an EAPC of -3.43 (95% CI: -3.32, -3.53). In contrast, resource-limited regions, particularly among males, experienced stagnation or even increases in IHD burden. The EAPC of ASDR in low-, low-middle-, and middle-SDI regions ranged from - 0.12 (95% CI: -0.04, -0.19) to 0.16 (95% CI: 0.09, 0.23). Among males, the values ranged from 0.22 (95% CI: 0.14, 0.29) to 0.55 (95% CI: 0.47, 0.62). The increase in IHD burden in these regions was primarily driven by rising levels of FPG and BMI. Younger populations (15-49 years) were disproportionately affected, showing increasing exposure to these metabolic risks.

CONCLUSION

Regional disparities in IHD burden persist, primarily driven by metabolic risk factors. Resource-abundant regions have benefitted from effective control of SBP and LDLc, whereas resource-limited regions face growing challenges, especially related to FPG and BMI. The use of secondary data from the GBD 2021 database provides a comprehensive global perspective but may not fully capture local variations in disease burden. Targeted public health strategies and early interventions are essential to reduce the growing IHD burden in these vulnerable populations.

Association between triglyceride-glucose (TyG) related indices and cardiovascular diseases and mortality among individuals with metabolic dysfunction-associated steatotic liver disease: a cohort study of UK Biobank

BACKGROUND

Triglyceride-glucose (TyG) related indices, which serve as simple markers for insulin resistance, have been closely linked to metabolic dysfunction-associated steatotic liver disease (MASLD), cardiovascular disease (CVD), and mortality. However, the prognostic utility of TyG-related indices in predicting the risk of CVD and mortality among patients with MASLD remains unclear.

METHODS

Data of 97,331 MASLD patients, with a median age of 58.0 years and free of CVD at baseline, were obtained from the UK Biobank. The TyG index, along with its combination with adiposity parameters (i.e. body mass index [BMI], waist circumference [WC], and waist-to-height ratio [WHtR]), were calculated. Cox proportional hazards models and restricted cubic spline (RCS) were performed to evaluate the associations between TyG-related indices and the risk of overall CVD, coronary heart disease (CHD), stroke, all-cause mortality, and cardiovascular mortality. Additionally, Harrell's C-index, net reclassification index (NRI), and integrated discrimination improvement index (IDI) were used to assess the predictive performance of these indices.

RESULTS

Over a median follow-up of 13.56 years, we identified 13,256 cases of overall CVD, 10,980 CHD, 2,926 stroke, 8,809 all-cause mortality, and 1,796 cardiovascular mortality. Compared with the lowest quartile of TyG-related indices, participants with MASLD in the high quartile of TyG-related indices had a significantly increased risk of incident overall CVD, CHD, stroke, and mortality. Specifically, the hazard ratios of occurring overall CVD in the fourth versus the first quartiles were 1.19 (95% confidence interval: 1.13-1.25) for TyG, 1.35 (1.28-1.42) for TyG-BMI, 1.33 (1.26-1.40) for TyG-WC, and 1.39 (1.32-1.46) for TyG-WHtR. RCS analyses indicated a nonlinear association of TyG with CVD outcomes (all P values for nonlinearity < 0.05), whereas there exhibited linear trends in TyG-BMI, TyG-WC, and TyG-WHtR with CVD outcomes (all P values for nonlinearity > 0.05, except for TyG-WC with stroke). Furthermore, TyG-WC and TyG-WHtR demonstrated the significantly higher C-index, NRI, and IDI in predicting risk of CVD and mortality in MASLD patients.

CONCLUSION

TyG-related indices, especially TyG-WC and TyG-WHtR, had significant predictive values for the risk of incident CVD and mortality in individuals with MASLD. TyG-related indices may serve as effective surrogate predictors of CVD and mortality in MASLD patients.

Joint association of triglyceride glucose index (TyG) and a body shape index (ABSI) with stroke incidence: a nationwide prospective cohort study

BACKGROUND

Triglyceride glucose index(TyG) and a body shape index(ABSI) are both independent predictor of stroke incidence or adverse prognosis but these two indicators seldom were combined to predict. The purpose of this study is to evaluate whether the combination of TyG and ABSI better predict the incidence of stroke.

METHODS

Based on the China Health and Retirement Longitudinal Study(CHARLS), 8,257 people aged 45 years and older without stroke were enrolled and followed up to 9 years. Sociodemographic information, health status, physical examination and blood data were collected retrospectively. Cox regressions were to determine the relationship between different groups and stroke incidence, using receiver operating characteristic curves to evaluate the diagnostic value. Meanwhile, subgroup analysis was performed to investigate the prediction performance among different population.

RESULTS

672(8.14%) of 8,257 participants had stroke incidence during 9 years. In the adjusted multivariate cox regression model, both TyG and ABSI were still predictors of stroke. The HR of TyG was 1.25(95%CI: 1.06-1.47) and the HR of ABSI was 1.33(95%CI: 1.06-1.68). Restricted cubic spline regression showed the associations between TyG or ABSI and stroke. The combination of TyG and ABSI had the highest diagnostic efficacy(AUC: 0.579, 95%CI: 0.553-0.597), compared to TyG(AUC:0.566, 95%CI: 0.544-0.587) and ABSI(AUC:0.533, 95%CI: 0.524-0.597). Kaplan-Meier curves showed that the highest cumulative stroke incidence was among people with high TyG and ABSI(TyG ≥ 8.5742, ABSI ≥ 0.0852; P < 0.0001), which had the highest HR of stroke incidence(HR:1.64, 95%CI:1.2-2.24).

CONCLUSION

The combined prediction of TyG and ABSI had higher clinical value and enabled earlier detection of the stroke in the general population, which could be monitored and intervened to reduce the overall burden of stroke.

Association of Triglyceride-Glucose Index, Triglyceride to High-Density Lipoprotein Cholesterol Ratio, and Related Parameters With Prehypertension and Hypertension

The objective of this study was to investigate the association between triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-c), triglyceride-glucose index (TyG), and related parameters (TyG-BMI, TyG-WC) with prehypertension and hypertension over 45 years old. According to the blood pressure diagnosis, the enrolled individuals were divided into two groups, which were prehypertension and hypertension. In multivariate logistic regression analysis, after adjusting for confounders, the highest quartile groups of TG/HDL-c, TyG, and related parameters showed a significantly increased risk of hypertension compared to the lowest quartile groups, and there was associated with hypertension when comparing the highest TG/HDL-c to the lowest TG/HDL-c and corresponding ORs were 1.416 (1.234, 1.625) and 1.029 (0.893, 1.187), respectively. Furthermore, when comparing the fourth quartile to the first quartile of TG/HDL-c, TyG index, and related parameters, respectively, both corresponding ORs of hypertension were higher than prehypertension. Elevated TyG, TyG-BMI, TyG-WC index, and TG/HDL-c ratio levels were associated with hypertension in individuals over 45 years. Moreover, the receiver operating characteristic curve was used to compare the predictive ability of each parameter in identifying people with hypertension suggested that the TyG-WC index ([Area under the curve] AUC: 0.601 [CI: 0.588-0.615]), TyG-BMI, and TyG were more significant than TG/HDL-c in distinguishing hypertension. However, in the prehypertension population, the area under the ROC curve for TyG-BMI (0.543 [CI: 0.530-0.556]) was better than that of other parameters. They have the potential to become cost-effective monitors in the hierarchical management of hypertension.

sJAM-C as a Potential Biomarker for Coronary Artery Stenosis: Insights from a Clinical Study in Coronary Heart Disease Patients

Purpose

Coronary artery stenosis caused by atherogenesis is a major pathological link in coronary heart disease (CHD), which is a leading cause of global morbidity and mortality. Junctional adhesion molecule C (JAM-C) presents more and more association with atherosclerosis. However, no studies have shown the relationship between soluble JAM-C (sJAM-C) and the degree of coronary artery stenosis. This study aimed to analyze the effect of sJAM-C on coronary artery stenosis and to verify whether sJAM-C could be a biomarker for coronary artery stenosis.

Patients and Methods

The participants registered at the Beijing Luhe Hospital, Capital Medical University in the cross-sectional study. A total of 121 patients without coronary stenosis and 408 patients with coronary artery stenosis were enrolled after matching age and sex. Demographic information, medication history, and laboratory data were collected. The level of serum sJAM-C was detected by enzyme-linked immunosorbent assay (ELISA) kits. We used the logistic regression model to evaluate the association between sJAM-C and coronary artery stenosis. Furthermore, the receiver operating characteristic (ROC) curve and area under curve (AUC) were used to evaluate the diagnostic value of sJAM-C on coronary artery stenosis.

Results

The serum level of sJAM-C was remarkably higher in patients with coronary artery stenosis than those without stenosis (p < 0.0001). Logistic regression models showed that there were positive association between serum sJAM-C level and coronary artery stenosis after adjustment, with corresponding ORs were 3.088 (95% CI 1.922-4.960, p < 0.0001). And the ROC curve revealed a sensitivity of 65.7% and specificity of 60.3% with AUC of 0.676 (95% CI 0.622-0.730) for the diagnosis of coronary artery stenosis with serum sJAM-C at a cut-off value of 18.1 pg/mL, indicating a certain diagnostic value.

Conclusion

In summary, higher serum sJAM-C level was possibly associated with the more severe coronary artery stenosis. Additionally, sJAM-C demonstrates a certain diagnostic value of coronary artery stenosis. These findings suggest sJAM-C may be a biomarker for coronary artery stenosis.

Relationships among Helicobacter pylori seropositivity, the triglyceride-glucose index, and cardiovascular disease: a cohort study using the NHANES database

BACKGROUND

Helicobacter pylori (H. pylori), a widely prevalent pathogen that can be cured through relatively simple medical methods, is thought to be potentially associated with the risk of cardiovascular diseases (CVD), although controversy remains. Currently, it is unclear whether the triglyceride-glucose index (TGI), a classic indicator of insulin resistance, influences the relationship between H. pylori infection and CVD. The present work explored the relationships between H. pylori seropositivity, the TGI and CVD, and the potential effect of TGI in this association.

METHODS

In this cross-sectional and cohort study, data from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and NHANES (1999-2000) were used. The effects of the TGI, H. pylori seropositivity, and their interaction on the risk of CVD were assessed using logistic regression models. The hazard ratios (HRs) and 95% confidence intervals (CI) for all-cause mortality (ACM) were calculated using the Cox proportional hazards model. Restricted cubic spline (RCS) curves were employed to investigate potential non-linear or linear relationships among the TGI, H. pylori seropositivity, occurrence of CVD, and ACM. Mediation analyses were employed to assess the potential effects of H. pylori seropositivity and TGI on the risk of CVD and mortality.

RESULTS

Of the 9,399 participants, 4,488 (47.75%) were H. pylori-immunoglobulin G (IgG)-positive, and 3,934 (41.86%) were diagnosed with CVD. In the general population, participants with a TGI ≥ 75th percentile who were positive for H. pylori-IgG antibody had the highest risk of developing CVD (odds ratio = 1.487; 95% CI: 1.088-2.033). Among patients with CVD, those with a TGI ≥ 75th percentile & positive for H. pylori-IgG antibody were at a higher ACM risk (HR = 1.227; 95% CI: 1.009-1.491). H. pylori exhibited a significant mediating effect on CVD occurrence (Pindir = 0.004) and mortality (Pindir = 0.004) via the TGI.

CONCLUSIONS

H. pylori seropositivity may indirectly elevate the risk of CVD and mortality via the TGI. Combining the patient's H. pylori serological status with their TGI could enhance the predictive ability for CVD occurrence and related mortality. Therefore, the clinical practice of screening for and eradicating H. pylori in CVD patients may be anticipated.

The association of coronary artery disease with heart rate at anaerobic threshold and respiratory compensatory point

Background

There is limited knowledge regarding the association between heart rate (HR) during different exercise phases and coronary artery disease (CAD). This study aimed to evaluate the relationship between four exercise-related HR metrics detected by cardiopulmonary exercise testing (CPET) and CAD. These metrics include HR at the anaerobic threshold (HRAT), HR at respiratory compensatory point (HRRCP), maximal HR (HRmax), and HR 60 s post-exercise (HRRec60s).

Methods

The 705 participants included 383 with CAD and 322 without CAD in Beijing Hospital, who underwent CPET between January 2021 and December 2022. The Logistic regression analysis was applied to estimate the odds ratio and the 95% confidence interval. Additionally, the multivariable Logistic regression analyses with restricted cubic splines were conducted to characterize the dose-response association and explore whether the relationship was linear or nonlinear.

Results

Our primary finding indicates that for each one-beat increase in HRAT, there is a 2.8% reduction in the adjusted risk of CAD in the general population. Similarly, a one-beat increase in HRRCP corresponds to a 2.6% reduction in the adjusted risk of CAD. Subgroup analyses revealed significant interactions between HRAT and factors such as sex, hypertension, and lung cancer, as well as between HRRCP and sex and hypertension, in relation to CAD. The dose-response analysis further confirmed that higher HRAT and HRRCP are associated with a reduced risk of CAD.

Conclusion

These results are suggestive of a good association between HRAT, HRRCP, and CAD. The lower HRAT, and HRRCP are signs of poor HR response to exercise in CAD. HRAT and HRRCP are potentially good indicators of poor HR response to exercise without considering maximal effort.

Impact of VO 2peak on the Clinical Outcomes of Older Patients With Coronary Heart Disease in China

PURPOSE

The aim of this study was to explore the role of cardiopulmonary exercise test parameters, especially peak oxygen uptake (VO 2peak ), in predicting the incidence of adverse cardiovascular events in older Chinese patients with coronary heart disease (CHD).

METHODS

Older patients with CHD who underwent cycle ergometer cardiopulmonary exercise test at the Cardiac Rehabilitation Clinic of Chinese PLA General Hospital from July 1, 2015 to January 31, 2020 were enrolled. The follow-up intervals were 6 mo. Cox regression was used to analyze the relationship between VO 2peak and adverse cardiovascular events. Restricted cubic splines and subgroup analyses were used to observe the relationship between VO 2peak and the hazard ratio (HR) of the primary end point event (PEE), which included a composite of all-cause death, nonfatal recurrent myocardial infarction, unscheduled revascularization, and stroke. The composite end point event was the PEE combined with cardiac rehospitalization.

RESULTS

A total of 1223 participants (mean age 68 ± 5 yr) were included. Median follow-up was 68 mo. Mean VO 2peak was 16.5 ± 4.0 mL/kg/min, and VO 2peak was an independent predictor of the PEE (HR = 0.929; 95% CI, 0.891-0.970; P = .001). This association was further validated by restricted cubic spline and subgroup analyses. Peak oxygen uptake was also an independent risk factor for the composite end point event (HR = 0.968; 95% CI, 0.941-0.996; P = .025).

CONCLUSION

In conclusion, VO 2peak is an independent risk factor for adverse cardiovascular events in older Chinese patients with CHD, and more optimal therapy should be recommended to patients with lower VO 2peak .

The triglyceride-glucose index is a predictor of major adverse cardiovascular events in patients with coronary artery disease and psoriasis: a retrospective cohort study

BACKGROUND

The association between the triglyceride-glucose (TyG) index and clinical outcomes in patients with both coronary artery disease (CAD) and psoriasis is unclear. This study investigated the association between the TyG index and major adverse cardiovascular events (MACE) in patients with both CAD and psoriasis.

METHODS

This retrospective cohort study included patients diagnosed with both CAD and psoriasis who underwent coronary angiography at the Fuwai Hospital, Beijing, China, between January 2017 and May 2022. The study endpoint was the occurrence of MACE or end of follow-up time. Multivariate Cox proportional analysis and restricted cubic splines (RCS) were used to determine the association between the TyG index and MACE. Receiver operating characteristic (ROC) curves were used to determine the optimal threshold value of the TyG index for predicting MACE.

RESULTS

This study enrolled 293 patients with both CAD and psoriasis, including 258 (88.1%) males with a mean age of 58.89 ± 9.61 years. Patients were divided into four groups based on the TyG quartiles: Q1 (N = 74), Q2 (N = 73), Q3 (N = 73), and Q4 (N = 73). After adjusting for the potential confounders, the TyG index was independently associated with MACE, both as a continuous variable (HR = 1.53, 95% CI = 1.03-2.28, P = 0.035) and as a categorical variable (Q1: reference; Q2: HR = 1.85, 95% CI = 0.88-3.87, P = 0.105; Q3: HR = 2.39, 95% CI = 1.14-5.00, P = 0.021; Q4: HR = 2.19, 95% CI = 1.001-4.81, P = 0.0497; P for trend = 0.039). RCS analysis showed an linear association between the TyG index and MACE (P-overall = 0.027, P-non-linear = 0.589). ROC curve analysis showed that the TyG index of ≥ 8.73 was the optimal threshold value (area under the ROC curve = 0.60, 95% CI 0.53-0.67). TyG index ≥ 8.73 was significantly associated with MACE (HR = 2.10, 95% CI = 1.32-3.34, P = 0.002). After adjustment for confounders, the TyG index showed independent association with MACE (HR = 2.00, 95% CI = 1.17-3.42, P = 0.011).

CONCLUSIONS

The TyG index showed a positive linear correlation with MACE in patients with both CAD and psoriasis. The TyG index of ≥ 8.73 might be the optimal threshold for predicting MACE.

Lipid-based insulin-resistance markers predict cardiovascular events in metabolic dysfunction associated steatotic liver disease

BACKGROUND

Insulin resistance (IR) is the cornerstone of Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD), pathophysiologically being the key link between MASLD, metabolic disorders, and cardiovascular (CV) diseases. There are no prospective studies comparing the predictive values of different markers of insulin resistance (IR) in identifying the presence of MASLD and the associated risk of cardiovascular events (CVEs).

METHODS

Post hoc analysis of the prospective Plinio Study, involving dysmetabolic patients evaluated for the presence of MASLD. The IR markers considered were Homeostatic Model Assessment for IR (HOMA-IR), Triglycerides-Glycemia (TyG) index, Triglycerides to High-Density Lipoprotein Cholesterol ratio (TG/HDL-C), Lipid Accumulation Product (LAP) and Visceral Adiposity Index (VAI). Receiver operative characteristic (ROC) analyses were performed to find the optimal cut-offs of each IR marker for detecting MASLD and predicting CVEs in MASLD patients. Logistic and Cox multivariable regression analyses were performed, after dichotomizing the IR markers based on the optimal cut-offs, to assess the factors independently associated with MASLD and the risk of CVEs.

RESULTS

The study included 772 patients (age 55.6 ± 12.1 years, 39.4% women), of whom 82.8% had MASLD. VAI (Area Under the Curve [AUC] 0.731), TyG Index (AUC 0.723), and TG/HDL-C ratio (AUC: 0.721) predicted MASLD but was greater with HOMA-IR (AUC: 0.792) and LAP (AUC: 0.787). After a median follow-up of 48.7 (25.4-75.8) months, 53 MASLD patients experienced CVEs (1.8%/year). TyG index (AUC: 0.630), LAP (AUC: 0.626), TG/HDL-C (AUC: 0.614), and VAI (AUC: 0.590) demonstrated comparable, modest predictive values in assessing the CVEs risk in MASLD patients.

CONCLUSION

In dysmetabolic patients HOMA-IR and LAP showed the best accuracy in detecting MASLD. The possible use of lipid-based IR markers in stratifying the CV risk in patients with MASLD needs further validation in larger cohorts.

Association of the triglyceride-glucose index with early-onset atherosclerotic cardiovascular disease events and all-cause mortality: a prospective cohort study

BACKGROUND

The association between the triglyceride glucose (TyG) index and the risk of early-onset atherosclerotic cardiovascular disease (ASCVD) events or all-cause mortality in young and middle-aged people is not fully elucidated.

METHODS

The present study included 64,489 young and middle-aged people who participated in the 2006 Kailuan Study physical examination. Multivariate Cox proportional hazards models and restricted cubic spline curves were used to assess the association of TyG index with early-onset ASCVD events and all-cause mortality.

RESULTS

During a median of 11-year follow-up, 1984 (3.08%) participants experienced at least one ASCVD event and 1,392 (2.16%) participants experienced all-cause death. A higher TyG index was significantly associated with a higher risk of early-onset ASCVD events (HR: 1.61, 95% CI 1.38-1.89) and all-cause mortality (HR: 1.39, 95% CI 1.17-1.65), respectively. For each unit increase in TyG index, the risk of early-onset ASCVD events increased by 20%. In addition, there was a non-linear association between the TyG index and early-onset ASCVD events (P for non-linear < 0.01), and a linear association between TyG index and all-cause mortality (P for non-linear = 0.476).

CONCLUSIONS

A higher TyG index is significantly associated with an increased incidence of early-onset ASCVD events and all-cause mortality in a young and middle-aged population from North China.

Triglyceride glucose index is associated with functional coronary artery stenosis in hypertensive patients

Background

The triglyceride glucose (TyG) index is an effective method for determining insulin resistance (IR). Limited research has explored the connection between the TyG index and functionally significant stenosis in hypertensive patients. Furthermore, the connections between the TyG index, fat attenuation index (FAI) and atherosclerotic plaque characteristics are also worth exploring.

Methods

The study screened 1622 hypertensive participants without coronary artery disease history who underwent coronary computed tomography angiography. The TyG index was calculated as ln (fasting glucose [mg/dL] * fasting TG [mg/dL]/2). Adverse plaque characteristics (HRPCs), high-risk plaques (HRPs), FAI, and CT-derived fractional flow reserve (FFRCT) were analyzed and measured for all patients. Functionally significant stenosis causing ischemia is defined as FFRCT ≤ 0.80. Two patient groups were created based on the FFRCT: the FFRCT < 0.80 group and the FFRCT > 0.80 group. In hypertensive patients, the association between the TyG index and FFRCT was examined applying a logistic regression model.

Results

The TyG index was higher for people with FFRCT ≤ 0.80 contrast to those with FFRCT > 0.80. After controlling for additional confounding factors, the logistic regression model revealed a clear connection between the TyG index and FFRCT ≤ 0.80 (OR = 1.718, 95% CI 1.097-2.690, p = 0.018). The restricted cubic spline analysis displayed a nonlinear connection between the TyG index and FFRCT ≤ 0.80 (p for nonlinear = 0.001). The TyG index increased the fraction of individuals with HRPs and HRPCs, FAI raised, and FFRCT decreased (p < 0.05). The multivariate linear regression analysis illustrated a powerfulcorrelation between high TyG index levels and FAI, FFRCT, positive remodeling (PR), and low-attenuation plaque (LAPs) (standardized regression coefficients: 0.029 [p = 0.007], -0.051 [p < 0.001], 0.029 [p = 0.027], and 0.026 [p = 0.046], separately).

Conclusion

In hypertensive patients, the TyG index showed an excellent association with a risk of FFRCT ≤ 0.80. Additionally, the TyG index was also linked to FAI, FFRCT, PR, and LAPs.

Association between different insulin resistance surrogates and all-cause mortality in patients with coronary heart disease and hypertension: NHANES longitudinal cohort study

BACKGROUND

Studies on the relationship between insulin resistance (IR) surrogates and long-term all-cause mortality in patients with coronary heart disease (CHD) and hypertension are lacking. This study aimed to explore the relationship between different IR surrogates and all-cause mortality and identify valuable predictors of survival status in this population.

METHODS

The data came from the National Health and Nutrition Examination Survey (NHANES 2001-2018) and National Death Index (NDI). Multivariate Cox regression and restricted cubic splines (RCS) were performed to evaluate the relationship between homeostatic model assessment of IR (HOMA-IR), triglyceride glucose index (TyG index), triglyceride glucose-body mass index (TyG-BMI index) and all-cause mortality. The recursive algorithm was conducted to calculate inflection points when segmenting effects were found. Then, segmented Kaplan-Meier analysis, LogRank tests, and multivariable Cox regression were carried out. Receiver operating characteristic (ROC) and calibration curves were drawn to evaluate the differentiation and accuracy of IR surrogates in predicting the all-cause mortality. Stratified analysis and interaction tests were conducted according to age, gender, diabetes, cancer, hypoglycemic and lipid-lowering drug use.

RESULTS

1126 participants were included in the study. During the median follow-up of 76 months, 455 participants died. RCS showed that HOMA-IR had a segmented effect on all-cause mortality. 3.59 was a statistically significant inflection point. When the HOMA-IR was less than 3.59, it was negatively associated with all-cause mortality [HR = 0.87,95%CI (0.78, 0.97)]. Conversely, when the HOMA-IR was greater than 3.59, it was positively associated with all-cause mortality [HR = 1.03,95%CI (1.00, 1.05)]. ROC and calibration curves indicated that HOMA-IR was a reliable predictor of survival status (area under curve = 0,812). No interactions between HOMA-IR and stratified variables were found.

CONCLUSION

The relationship between HOMA-IR and all-cause mortality was U-shaped in patients with CHD and hypertension. HOMA-IR was a reliable predictor of all-cause mortality in this population.

Associations of the triglyceride-glucose index and remnant cholesterol with coronary artery disease: a retrospective study

BACKGROUND

Remnant cholesterol (RC) represents a low-cost and readily measured lipid index that contributes significantly to residual cardiovascular disease risk. The triglyceride-glucose (TyG) index exhibits a significant correlation with cardiovascular disease occurrence. However, RC and the TyG index have rarely been examined for their potentials in predicting coronary artery disease (CAD). Accordingly, the study was designed to validate the correlations of these two biomarkers with CAD and to compare the forecasted values of these two biomarkers for newly diagnosed CAD.

METHODS

Totally 570 subjects firstly administered coronary angiography were enrolled, including 431 newly diagnosed CAD cases and 139 individuals without CAD. The individuals were classified into two groups according to CAD diagnosis. RC was derived as total cholesterol content (mmol/L) - (high density lipoprotein cholesterol content + low density lipoprotein cholesterol content; both in mmol/L). The TyG index was determined as ln (fasting triglyceride level [mg/dL] × fasting plasma glucose level [mg/dL])/2.

RESULTS

Baseline feature analysis revealed significant differences in RC and the TyG index between the CAD and non-CAD groups (both P < 0.001). RC and the TyG index were independent risk factors for CAD in accordance with logistic regression analysis (both P < 0.05). Moreover, spearman correlation analysis elucidated CAD had a more remarkable correlation with the TyG index compared with RC (both P < 0.001). Furthermore, according to receiver operating characteristic curve analysis, the TyG index was better than RC in predicting CAD.

CONCLUSIONS

The TyG index and RC have significant associations with CAD. Compared with RC, the TyG index possesses a closer correlation with CAD and a higher predictive value for CAD.

Association between the triglyceride-glucose index and 1-year major adverse cardiovascular events in patients with coronary heart disease and hypertension

BACKGROUND

The triglyceride-glucose (TyG) index has been proposed as a potential predictor of adverse prognosis of coronary heart disease (CHD). However, its prognostic value in patients with CHD and hypertension remains unclear. This study aimed to evaluate the association between the TyG index and the 1-year risk of major adverse cardiovascular events (MACEs) in patients with CHD and hypertension.

METHODS

The data for the study were taken from the Hospital Information System database in China-Japan Friendship Hospital which contained over 10,000 cardiovascular admissions from 2019 to 2022. The Boruta algorithm was performed for feature selection. The study used univariable analysis, multivariable logistic regression analysis, and restricted cubic spline (RCS) regression to evaluate the association between the TyG index and the 1-year risk of MACEs in patients with CHD and hypertension.

RESULTS

After applying inclusion and exclusion criteria, a total of 810 patients with CHD and hypertension were included in the study with a median TyG index of 8.85 (8.48, 9.18). Using the lowest TyG index quartile as the reference, the fully adjusted ORs (95% CIs) for 1-year MACEs for TyG index Q2, Q3, and Q4 were 1.001 (0.986 ~ 1.016), 1.047 (1.032 ~ 1.062), and 1.760 (1.268 ~ 2.444), respectively. After adjusting for all confounders, we found that those with the highest TyG index had a 47.0% increased risk of MACEs over the 1-year follow-up (OR 1.470, 95% CI 1.071 ~ 2.018). The results in the subgroup analysis were similar to the main analyses. RCS model suggested that the TyG index was nonlinearly associated with the 1-year risk of MACEs (P for nonlinear < 0.001).

CONCLUSION

This study shows that the elevated TyG index is a potential marker of adverse prognosis among patients with CHD and hypertension and informs the development of clinical decisions to improve outcomes.

Prognostic value of triglyceride glucose index in population at high cardiovascular disease risk

BACKGROUND

Early identification of populations at high cardiovascular disease (CVD) risk and improvement of risk factors can significantly decrease the probability of CVD development and improve outcomes. Insulin resistance (IR) is a CVD risk factor. The triglyceride glucose (TyG) index is a simple and reliable index for evaluating IR. However, no clinical studies on the prognostic value of the TyG index in a high risk CVD population have been conducted. This study evaluated the relationship between the TyG index and prognosis in a high risk CVD population.

METHODS

This study enrolled 35,455 participants aged 35-75 years who were at high CVD risk and visited selected health centers and community service centers between 2017 and 2021. Their general clinical characteristics and baseline blood biochemical indicators were recorded. The TyG index was calculated as ln[fasting triglyceride (mg/dl)× fasting blood glucose (mg/dl)/2]. The endpoints were all-cause death and cardiovascular death during follow-up. Cox proportional hazard models and restricted cubic spline (RCS) analysis were used to evaluate the correlation between the TyG index and endpoints.

RESULTS

In the overall study population, the mean age of all participants was 57.9 ± 9.6 years, 40.7% were male, and the mean TyG index was 8.9 ± 0.6. All participants were divided into two groups based on the results of the RCS analysis, with a cut-off value of 9.83. There were 551 all-cause deaths and 180 cardiovascular deaths during a median follow-up time of 3.4 years. In the multivariate Cox proportional hazard model, participants with a TyG index ≥ 9.83 had a higher risk of all-cause death (Hazard ratio [HR] 1.86, 95% Confdence intervals [CI] 1.37-2.51, P<0.001) and cardiovascular death (HR 2.41, 95%CI 1.47-3.96, P = 0.001) than those with a TyG index < 9.83. Subgroup analysis revealed that there was no interaction between the TyG index and variables in all subgroup analyses.

CONCLUSIONS

The high TyG index was associated with an increased risk of all-cause death and cardiovascular death in people at high risk of CVD. This finding demonstrates the value of the TyG index in the primary prevention of CVD.

TRIAL REGISTRATION

retrospectively registered, the registration number is K2022-01-005 and the date is 2022.01.30.