Triglyceride-glucose index is associated with severe obstructive coronary artery disease and atherosclerotic target lesion failure among young adults

© 2023. BioMed Central Ltd., part of Springer Nature..

BACKGROUND: Early diagnosis and treatment effectiveness of early-onset coronary artery disease (EOCAD) are crucial, and non-invasive predictive biomarkers are needed for young adults. We aimed to evaluate the usefulness of the triglyceride-glucose (TyG) index, a novel marker of insulin resistance, in identifying young CAD patients and predicting their risk of developing target lesion failure (TLF).

METHODS: We recruited EOCAD patients (luminal narrowing ≥ 70%) and controls free from CAD (luminal narrowing < 30%), both aged 45 years or younger, from 38 hospitals in China between 2017 and 2020. EOCAD patients who underwent successful percutaneous coronary intervention were followed for incident TLF. TyG index was defined as Ln [fasting triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2]. We used logistic regression and Cox proportional hazards modeling to evaluate the association of TyG index with prevalent EOCAD and incident TLF, respectively. The discriminatory ability of TyG index was assessed by the area under the receiver-operating characteristic curve (AUC).

RESULTS: Among the included 1513 EOCAD patients (39.6 ± 4.4 years, 95.4% male) and 1513 age-matched controls (39.0 ± 4.4 years, 46.4% male), TyG index was positively associated with the prevalence of EOCAD (adjusted odds ratio: 1.40, 95% confidence interval [CI] 1.23-1.60, per standard deviation [SD] increase in TyG index). The addition of TyG index to an empirical risk model provided an improvement in diagnostic ability for EOCAD, with a net reclassification improvement of 0.10 (95% CI 0.03-0.17, p = 0.005). During a medium of 33 month (IQR: 31-34 months) follow-up, 43 (3.3%) patients experienced TLF. Multivariate Cox regression model revealed that TyG index was an independent risk factor for TLF (adjusted hazard ratio [HR]: 2.410, 95% CI 1.07-5.42 comparing the top to bottom TyG index tertile groups; HR: 1.30, 95% CI 1.01-1.73, per SD increase in TyG index). Compared with a model of conventional risk factors alone, the addition of the TyG index modestly improved the AUC (0.722-0.734, p = 0.04) to predict TLF.

CONCLUSIONS: TyG index is positively associated with prevalent EOCAD and incident TLF. TyG index appeared to be a valuable component of future efforts to improve CAD risk stratification and TLF outcome prediction among young adults.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:22

Enthalten in:

Cardiovascular diabetology - 22(2023), 1 vom: 21. Okt., Seite 283

Sprache:

Englisch

Beteiligte Personen:

Shali, Shalaimaiti [VerfasserIn]
Luo, Lingfeng [VerfasserIn]
Yao, Kang [VerfasserIn]
Sun, Xiangdong [VerfasserIn]
Wu, Hongyi [VerfasserIn]
Zhang, Shuning [VerfasserIn]
Xu, Lili [VerfasserIn]
Gao, Wei [VerfasserIn]
Li, Jianxuan [VerfasserIn]
Qian, Juying [VerfasserIn]
Zheng, Yan [VerfasserIn]
Dai, Yuxiang [VerfasserIn]
Ge, Junbo [VerfasserIn]
the GRAND investigators [VerfasserIn]
Shali, Shalaimaiti [Sonstige Person]
Luo, Lingfeng [Sonstige Person]
Yao, Kang [Sonstige Person]
Sun, Xiangdong [Sonstige Person]
Wu, Hongyi [Sonstige Person]
Zhang, Shuning [Sonstige Person]
Xu, Lili [Sonstige Person]
Gao, Wei [Sonstige Person]
Li, Jianxuan [Sonstige Person]
Qian, Juying [Sonstige Person]
Zheng, Yan [Sonstige Person]
Dai, Yuxiang [Sonstige Person]
Ge, Junbo [Sonstige Person]

Links:

Volltext

Themen:

Biomarkers
Blood Glucose
Coronary artery disease
Early-onset
Glucose
IY9XDZ35W2
Insulin resistance
Journal Article
Research Support, Non-U.S. Gov't
Target lesion failure
Triglycerides
TyG index

Anmerkungen:

Date Completed 02.11.2023

Date Revised 22.11.2023

published: Electronic

Citation Status MEDLINE

doi:

10.1186/s12933-023-02004-1

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM363581081