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Abstract
Objective
We aimed to investigate the prognostic value of the triglyceride-glucose (TyG) index combined the with Global Registry of Acute Coronary Events (GRACE) score in adult acute coronary syndrome (ACS) patients with type 2 diabetes mellitus (T2DM) who underwent percutaneous coronary intervention (PCI).
Methods
The study enrolled total 899 ACS patients with T2DM who underwent PCI. TyG index and the GRACE risk score were calculated and assessed by median. The correlation was analyzed by Spearman’s rank correlation coefficient. The cumulative major adverse cardiovascular event (MACE) curve was generated using the Kaplan–Meier method. Multivariate Cox regression was used to identify predictors of MACEs. Additionally, the receiver operating characteristic curve (ROC), net reclassification index (NRI) and Integrated Discrimination Improvement (IDI) were applied to analyze the performance of each single factor index and combined multivariate index in predicting MACE.
Results
In the ACS patients with T2DM after PCI, there were significant differences in the TyG index and GRACE risk score between the MACE group and the MACE-free group (P < 0.001). Kaplan–Meier analysis showed that the TyG index combined with the GRACE risk score was positively correlated with the occurrence of MACEs (log rank P < 0.001). Multivariate Cox regression analyses showed that the TyG index, the GRACE risk score, and the TyG index combined with the GRACE risk score were independent predictors of long-term MACEs (adjusted HR: 1.805; 95% CI: 1.479–2.203, P < 0.001; adjusted HR: 1.012; 95% CI: 1.009–1.016, P < 0.001; and adjusted HR: 2.337; 95% CI: 1.805–3.025, P < 0.001, respectively). Correlation analysis indicated that the TyG index was positively correlated with the GRACE risk score (R = 0.140, P < 0.001). The analysis of AUC, NRI and IDI revealed that the combined multivariate index performed better prognostic role than each single factor index in predicting the occurrence of MACE.
Conclusion
Both the GRACE risk score and the TyG index could be significant and independent predictors of clinical outcomes in ACS patients with T2DM after PCI. A combination of them could be enhanced predictions of clinical outcomes in these patients.
Data Sharing Statement
Unless there are legal or ethical reasons not to do so, datasets will be provided from corresponding authors upon request in accordance with the original ethics and approval of relevant government authorities. For ethical and moral reasons, the data are not made public.
Acknowledgments
This work was supported by the National Natural Science Foundation of China (Nos. 82222007, 82170281, and U2004203), the Henan Thousand Talents Program (No. ZYQR201912131), and the Excellent Youth Science Foundation of Henan Province (No. 202300410362), Central Plains Youth Top Talent, Advanced funds (No. 2021-CCA-ACCESS-125).
Disclosure
The authors declare that they have no potential conflicts of interest for this work.