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Original investigation
Predictive Effect of Triglyceride‑Glucose Index on Clinical Events In Patients With Type 2 Diabetes Mellitus and Acute Myocardial Infarction: Results From an Observational Cohort Study In China
Hongwei Li
Capital Medical University
Corresponding Author
License:
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Background: Triglyceride glucose (TyG) index is considered a reliable alternative marker of insulin resistance and an independent predictor of cardiovascular outcomes. However, the prognostic value of TyG index in patients with type 2 diabetes mellitus (T2DM) and acute myocardial infarction (AMI) remains unclear.
Methods: A total of 1932 consecutive patients with T2DM and AMI were enrolled in this study. Patients were divided into tertiles according to their TyG index levels. The incidences of major adverse cardiac and cerebral events (MACCEs), including all-cause death, non-fatal MI, non-fatal stroke, cardiac rehospitalization and revascularization, were recorded. The TyG index was calculated as the ln [fasting triglycerides (mg/dL) ×fasting plasma glucose (mg/dL)/2].
Results: Kaplan-Meier curves showed that the incidences of cardiac rehospitalization (p=0.001), revascularization (p<0.001) and composite MACCEs (p=0.027) increased with TyG index tertiles. Multivariable Cox regression models revealed that the TyG index was positively associated with all-cause death, cardiovascular death, cardiac rehospitalization, revascularization and composite MACCEs. The addition of TyG index to a baseline risk model had an incremental effect on the predictive value for composite MACCEs [AUC: 0.663 vs. 0.708, p<0.001].
Conclusions: The TyG index was significantly associated with MACCEs, suggesting that the TyG index may be a valid marker for risk stratification and prognosis in patients with T2DM and AMI.
Trial registration: retrospectively registered
Keywords
Insulin resistance (IR), triglyceride-glucose index (TyG index), type 2 diabetes mellitus (T2DM) , acute myocardial infarction (AMI), major adverse cardiac and cerebral events (MACCEs)
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CURRENT STATUS: Under Revision
Version 1
Posted 01 Dec, 2020
No community comments so far
Editorial decision: Major Revision
On 17 Dec, 2020
Review #4 received
Received 16 Dec, 2020
Review #2 received
Received 30 Nov, 2020
Review #3 received
Received 30 Nov, 2020
Reviewer #4 agreed
On 25 Nov, 2020
Reviewer #3 agreed
On 25 Nov, 2020
Reviewer #2 agreed
On 23 Nov, 2020
Reviewers invited
Invitations sent on 22 Nov, 2020
Reviewer #1 agreed
On 22 Nov, 2020
Review #1 received
Received 22 Nov, 2020
Editor assigned
On 21 Nov, 2020
Submission checks complete
On 21 Nov, 2020
Editor invited
On 21 Nov, 2020
First submitted
On 20 Nov, 2020
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Subject Areas
Cardiac & Cardiovascular Systems
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This preprint is under consideration at Cardiovascular Diabetology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Original investigation
Predictive Effect of Triglyceride‑Glucose Index on Clinical Events In Patients With Type 2 Diabetes Mellitus and Acute Myocardial Infarction: Results From an Observational Cohort Study In China
Hongwei Li
Capital Medical University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 01 Dec, 2020
No community comments so far
Editorial decision: Major Revision
On 17 Dec, 2020
Review #4 received
Received 16 Dec, 2020
Review #2 received
Received 30 Nov, 2020
Review #3 received
Received 30 Nov, 2020
Reviewer #4 agreed
On 25 Nov, 2020
Reviewer #3 agreed
On 25 Nov, 2020
Reviewer #2 agreed
On 23 Nov, 2020
Reviewers invited
Invitations sent on 22 Nov, 2020
Reviewer #1 agreed
On 22 Nov, 2020
Review #1 received
Received 22 Nov, 2020
Editor assigned
On 21 Nov, 2020
Submission checks complete
On 21 Nov, 2020
Editor invited
On 21 Nov, 2020
First submitted
On 20 Nov, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Triglyceride glucose (TyG) index is considered a reliable alternative marker of insulin resistance and an independent predictor of cardiovascular outcomes. However, the prognostic value of TyG index in patients with type 2 diabetes mellitus (T2DM) and acute myocardial infarction (AMI) remains unclear.
Methods: A total of 1932 consecutive patients with T2DM and AMI were enrolled in this study. Patients were divided into tertiles according to their TyG index levels. The incidences of major adverse cardiac and cerebral events (MACCEs), including all-cause death, non-fatal MI, non-fatal stroke, cardiac rehospitalization and revascularization, were recorded. The TyG index was calculated as the ln [fasting triglycerides (mg/dL) ×fasting plasma glucose (mg/dL)/2].
Results: Kaplan-Meier curves showed that the incidences of cardiac rehospitalization (p=0.001), revascularization (p<0.001) and composite MACCEs (p=0.027) increased with TyG index tertiles. Multivariable Cox regression models revealed that the TyG index was positively associated with all-cause death, cardiovascular death, cardiac rehospitalization, revascularization and composite MACCEs. The addition of TyG index to a baseline risk model had an incremental effect on the predictive value for composite MACCEs [AUC: 0.663 vs. 0.708, p<0.001].
Conclusions: The TyG index was significantly associated with MACCEs, suggesting that the TyG index may be a valid marker for risk stratification and prognosis in patients with T2DM and AMI.
Trial registration: retrospectively registered
Figure 1
Figure 1
Figure 2
Figure 2
Figure 3
Figure 3