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

Abstract

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.

Keywords: Coronary artery disease; MACE; Psoriasis; Triglyceride-glucose index.

Fig. 1

Flowchart of study population. Abbreviations TyG index, triglyceride-glucose index; CAD, coronary artery disease

Fig. 2

Restricted cubic splines for the association between TyG index and MACEs. Abbreviations TyG index, triglyceride-glucose index; MACEs, major adverse cardiovascular events; HR, hazard ratio

Fig. 3

Receiver Operating Characteristic curve for TyG index in predicting MACEs

Fig. 4

The cumulative rates of MACEs stratified by a TyG index ≥ 8.73. Abbreviations: TyG index, triglyceride-glucose index; MACEs, major adverse cardiovascular events

Fig. 5

Stratified analyses of the association between TyG index and MACEs. *Adjusted for age, sex, smoking status, hypertension, T2DM, stroke, and admission for ACS, use of RAASI, platelet count, hsCRP levels, LDL-C, LVEF, presence of LM/TVD, angulated lesion, and PCI therapy. Abbreviations: TyG index, triglyceride-glucose index; MACEs, major adverse cardiovascular events; HTN, hypertension; T2DM, type 2 diabetes mellitus; ACS, acute coronary syndrome; RAASI, renin-angiotensin-aldosterone system inhibitors; hsCRP, high sensitivity C-reactive protein; LDL-C, low-density lipoprotein cholesterol; LVEF, left ventricular ejection fraction; LM/TVD, left main or three-vessel disease; PCI, percutaneous coronary intervention