The role of triglyceride glucose index in predicting in-hospital adverse cardiovascular outcomes in patients with acute coronary syndrome

Previous studies have shown the association of triglyceride glucose (TyG) index with metabolic syndrome (MetS), cardiovascular diseases (CAD) and long-term adverse cardiovascular outcomes. However, to best our knowledge, the relation between TyG index and in-hospital adverse cardiovascular outcomes in acute coronary syndrome (ACS) has not been reported yet. Hence, in this study, we aimed to evaluate the role of the TyG index in predicting in-hospital adverse cardiovascular outcomes in ACS and to compare its performance with the Global Acute Coronary Events Register (GRACE) risk score. 170 patients diagnosed with ACS and underwent coronary angiography were retrospectively analyzed. The TyG index was calculated using the following formula: ln [fasting triglycerides (mg/dL)×fasting blood glucose (mg/dL)/2]. Receiver operating characteristics (ROC) curve analysis was used to evaluate the performance of the TyG index and GRACE risk score in predicting in-hospital adverse cardiovascular outcomes. A binary logistic regression model was applied to determine the independent predictors of in-hospital adverse cardiovascular outcomes. In the initial analysis, the patients with adverse cardiovascular outcomes had high TyG index and GRACE risk scores (p=0.011, p

Keywords:

acute coronary syndrome, cardiovascular outcomes GRACE, triglyceride glucose index,

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Fox, K.A., Dabbous, O.H., Goldberg, R.J., Pieper, K.S., Eagle, K.A., Van de Werf, F., Avezum, A., Goodman, S.G., Flather, M.D., Anderson, F.A. Jr., Granger, C.B., 2006. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE). BMJ. 333, 1091.
Guerrero-Romero, F., Simental-Mendía, L.E., González-Ortiz, M., Martínez-Abundis, E., Ramos-Zavala, M.G., Hernández-González, S.O., Jacques-Camarena, O., Rodríguez-Morán, M., 2010. The product of triglycerides and glucose, a simple measure of insulin sensitivity comparison with the euglycemic–hyperinsulinemic clamp. J Clin Endocrinol Metab. 95, 3347-51.
Hamm, C.W., Bassand, J.P., Agewall, S., Bax, J., Boersma, E., Bueno, H., Caso, P., Dudek, D., Gielen, S., Huber, K., Ohman, M., Petrie, M.C., Sonntag, F., Uva, M.S., Storey, R.F., Wijns, W., Zahger, D., 2011. ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST segment elevation of the European Society of Cardiology. Eur Heart J. 32, 2999-3054.
Hu, C., Zhang, J., Liu, J., Liu, Y., Gao, A., Zhu, Y., Zhao, Y., 2020. Discordance between the triglyceride glucose index and fasting plasma glucose or HbA1C in patients with acute coronary syndrome undergoing percutaneous coronary intervention predicts cardiovascular events: a cohort study from China. Cardiovasc Diabetol. 19, 116.
Jin, J.L., Cao, Y.X., Wu, L.G., You, X.D., Guo, Y.L., Wu, N.Q., Zhu, C.G., Gao, Y., Dong, Q.T., Zhang, H.W., Sun, D., Liu, G., Dong, Q., Li, J.J., 2018. Triglyceride glucose index for predicting cardiovascular outcomes in patients with coronary artery disease. J Thorac Dis. 10, 6137-46.
Laakso, M., Kuusisto, J., 2014. Insulin resistance and hyperglycaemia in cardiovascular disease development. Nat Rev Endocrinol. 10, 293-302.
Lee, D.Y., Lee, E.S., Kim, J.H., Park, S.E., Park, C.Y., Oh, K.W., Park, S.W., Rhee, E.J., Lee, W.Y., 2016. Predictive value of triglyceride glucose index for the risk of incident diabetes: a 4-year retrospective longitudinal study. PLoS ONE. 11, 0163465.
Ma, X., Dong, L., Shao, Q., Cheng, Y., Lv, S., Sun, Y., Shen, H., Wang, Z., Zhou, Y., Liu, X., 2020. Triglyceride glucose index for predicting cardiovascular outcomes after percutaneous coronary intervention in patients with type 2 diabetes mellitus and acute coronary syndrome. Cardiovasc Diabetol. 19, 31.
Mao, Q., Zhou, D., Li, Y., Wang, Y., Xu, S.C., Zhao, X.H., 2019. The triglyceride-glucose index predicts coronary artery disease severity and cardiovascular outcomes in patients with non-ST segment elevation acute coronary syndrome. Dis. Markers. 6891537.
Muller, D.W., Topol, E.J., Ellis, S.G., Sigmon, K.N., Lee, K., Califf, R.M., 1991. Multivessel coronary artery disease: a key predictor of short-term prognosis after reperfusion therapy for acute myocardial infarction. Am Heart J. 121, 1042-49.
Ormazabal, V., Nair, S., Elfeky, O., Aguayo, C., Salomon, C., Zuñiga, F.A., 2018. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol. 17, 122.
Park, G.M., Cho, Y.R., Won, K.B., Yang, Y.J., Park, S., Ann, S.H., Kim, Y.G., Park, E.J., Kim, S.J., Lee, S.G., Yang, D.H., Kang, J.W., Lim, T.H., Kim, H.K., Choe, J., Lee, S.W., Kim, Y.H., 2020. Triglyceride glucose index is a useful marker for predicting subclinical coronary artery disease in the absence of traditional risk factors. Lipids Health Dis. 19, 7.
Perelshtein Brezinov, O., Klempfner, R., Zekry, S.B., Goldenberg, I., Kuperstein, R., 2017. Prognostic value of ejection fraction in patients admitted with acute coronary syndrome: A real world study. Medicine (Baltimore). 96, 6226.
Sánchez-Íñigo, L., Navarro-González, D., Pastrana-Delgado, J., Fernández Montero, A., Martínez, J.A., 2016. Association of triglycerides and new lipid markers with the incidence of hypertension in a Spanish cohort. J Hypertens. 34, 1257-65.
Sidney, S., Quesenberry. C.P.Jr., Jaffe, M.G., Sorel, M., Nguyen-Huynh, M.N., Kushi, L.H., Go, A.S., Rana, J.S., 2016. Recent Trends in Cardiovascular Mortality in the United States and Public Health Goals. JAMA Cardiol. 1, 594-9.
Thai, P.V., Tien, H.A., Minh, H., Valensi, P., 2020. Triglyceride glucose index for the detection of asymptomatic coronary artery stenosis in patients with type 2 diabetes. Cardiovasc Diabetol. 19, 137.
Townsend, N., Nichols, M., Scarborough, P., Rayner, M., 2015. Cardiovascular disease in Europe-epidemiological update 2015. Eur Heart J. 36, 2696-2705.
Vasques, A.C., Novaes, F.S., de Oliveira Mda, S., Souza, J.R., Yamanaka, A., Pareja, J.C., Tambascia, M.A., Saad, M.J., Geloneze, B., 2011. TyG index performs better than HOMA in a Brazilian population: a hyperglycemic clamp validated study. Diabetes Res Clin Pract. 93, 98-100.
Zhang. Y., Ding, X., Hua, B., Liu, Q., Gao, H., Chen, H., Zhao, X.Q., Li, W., Li, H., 2020. High triglyceride-glucose index is associated with adverse cardiovascular outcomes in patients with acute myocardial infarction. Nutr Metab Cardiovasc Dis. 30, 2351-62.