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. 2025 Sep 1;24(1):357.
doi: 10.1186/s12933-025-02858-7.

Association between dynamic changes in the triglyceride-glucose index and prognosis in patients with acute ST-segment elevation myocardial infarction

Haiyan Jia #  1 , Weifeng Zhang #  2 , Shengqi Jia #  3 , Xinwei Jia #  4 , Shixin Kang  1
Affiliations

Association between dynamic changes in the triglyceride-glucose index and prognosis in patients with acute ST-segment elevation myocardial infarction

Haiyan Jia et al. Cardiovasc Diabetol. .

Abstract

Background: The Triglyceride-Glucose (TyG) index is a surrogate marker of insulin resistance and has been associated with cardiovascular outcomes. However, most studies used single-timepoint measurements, failing to capture its dynamic changes after STEMI.

Methods: In this retrospective cohort study, 1,092 STEMI patients undergoing PCI were followed for five years. TyG index was measured at baseline and at 3, 6, 9, and 12 months post-discharge. Group-Based Trajectory Modeling (GBTM) was used to identify TyG index trajectories. Cox regression and Kaplan-Meier analysis evaluated their association with major adverse cardiovascular events (MACE).

Results: Three distinct TyG trajectories were identified: persistently high (n = 92), moderate (n = 196), and rapid decline (n = 804). The rapid decline group had significantly lower MACE incidence compared to the persistently high group (P < 0.001). TyG trajectory was an independent predictor of outcomes.

Conclusion: Distinct TyG trajectories after STEMI are associated with long-term prognosis. A persistently high TyG trajectory indicates elevated cardiovascular risk, suggesting its potential role in secondary prevention.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All participants provided written informed consent prior to their inclusion in the study. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of Patient Selection
Fig. 2
Fig. 2
Post-discharge 12-month Trajectories of the TyG Index in STEMI Patients Following PCI (A-E)
Fig. 3
Fig. 3
Kaplan-Meier Curves Comparing Ischemia-Driven Target Vessel Revascularization Events Among the Three Trajectory Groups
Fig. 4
Fig. 4
Kaplan-Meier Curves Comparing heart failure rehospitalization Among the Three Trajectory Groups
Fig. 5
Fig. 5
Kaplan-Meier Curves Comparing non-fatal acute myocardial infarction Among the Three Trajectory Groups
Fig. 6
Fig. 6
Kaplan-Meier Curves Comparing cardiac death Among the Three Trajectory Groups
Fig. 7
Fig. 7
Kaplan-Meier Curves Comparing MACEs Among the Three Trajectory Groups
Fig. 8
Fig. 8
Comparison of Hazard Ratios for MACE Events Between Trajectory 1 and Trajectory 3 Across Different Clinical Subgroups
Fig. 9
Fig. 9
Comparison of Hazard Ratios for MACE Events Between Trajectory 1 and Trajectory 2 Across Different Clinical Subgroups
See this image and copyright information in PMC

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