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. 2023 Nov 8;22(1):305.
doi: 10.1186/s12933-023-02018-9.

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

Shiyi Tao  1   2 , Lintong Yu  2 , Jun Li  3 , Li Huang  4 , Xuanchun Huang  1 , Wenjie Zhang  1   2 , Zicong Xie  1 , Yuqing Tan  1   2 , Deshuang Yang  4
Affiliations

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

Shiyi Tao et al. Cardiovasc Diabetol. .

Abstract

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.

Keywords: Coronary Heart Disease; Hypertension; Insulin resistance; Major adverse cardiovascular events; Triglyceride-glucose index.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the detailed selection process. CHD, coronary heart disease; MACE, major adverse cardiovascular event
Fig. 2
Fig. 2
Feature selection for the relationship between various TyG indices and the risk of 1-year MACEs analyzed by the Boruta algorithm. (A). The process of feature selection. (B). The value evolution of Z-score in the screening process. The horizontal axis shows the name of each variable and the number of iterations for the algorithm in Fig. 2-A and -B, respectively. While the vertical axis represents the Z-value of each variable. The green boxes and lines represent confirmed variables, the yellow ones represent tentative attributes, and the red ones represent rejected variables in the model calculation. TyG, triglyceride-glucose; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; HR, heart rate; CKD, chronic kidney disease; OMI, old myocardial infarction; CVD, cardiovascular disease; ACEI, angiotensin converting enzyme inhibitor; ARB, angiotensin receptor blocker; CCB, calcium channel blockers; TC, total cholesterol; TG, triglyceride; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; HCY, homocysteine; Hs-CRP, hypersensitive C-reactive protein; Scr, serum creatinine; FBG, fasting blood glucose; HbA1c, glycosylated hemoglobin; baPWV, brachial-ankle pulse wave velocity; ABI, ankle-brachial index; FMD, brachial artery flow-mediated vasodilatation; LAD, left atrial diameter; LVDd, left ventricular end-diastolic diameter; IVST, interventricular septal thickness; PWT, left ventricular posterior wall thickness; LVEF, left ventricular ejection fraction
Fig. 3
Fig. 3
Analysis of the relationship between the TyG index and the risk of 1-year MACEs. (A) Multivariable RCS regression showed the nonlinear association between the TyG index and the risk of 1-year MACEs after full adjustment. The cut-off value of TyG index in predicting MACEs was 8.85; (B) Kaplan-Meier analysis results illustrated the cumulative incidence of 1-year risk of MACEs in patients with both CHD and hypertension in various groups divided by the cut-off value of TyG index. TyG triglyceride-glucose; RCS, restricted cubic spline
Fig. 4
Fig. 4
Performance evaluation of Model 3 and the conventional model. The area under the curve of (A) Model 3 and (B) conventional model was analyzed by the receiver operating characteristic curve analysis
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