Triglyceride–Glucose Index as a Predictor of Major Adverse Cardiovascular Events in Post-PCI Patients Diagnosed with In-Stent Restenosis

Abstract

Background

The triglyceride–glucose index (TyG) is a reliable indicator for predicting the prognosis of patients with coronary heart disease (CAD) after percutaneous coronary intervention (PCI). However, its influence on patients with in-stent restenosis (ISR) is unclear. This study was designed to evaluate the association between the TyG index and the occurrence of major adverse cardiovascular events (MACEs) after PCI in patients with ISR.

Methods

This retrospective study included 1654 patients who underwent PCI between 2016 and 2022 at Nanjing First Hospital. Patients were stratified into three groups based on the quantile level of the TyG index. The TyG index was determined as Ln (triglycerides [mg/dL] × fasting plasma glucose [mg/dL]/2).

Results

Individuals with the highest TyG index showed an increased risk of MACEs compared to those with the lowest level of the TyG index (HR 1.60; 95% CI 1.11–2.30; P = 0.01). When analyzing the TyG index as a continuous variable, each standard deviation increase was associated with an HR of 1.51 (95% CI: 1.11–2.05; P = 0.01). For the male subgroup and the diabetes subgroup, this trend was even more pronounced (HR 1.269; 95% CI 1.055–1.527; P = 0.011; HR 1.385; 95% CI 1.125–1.706; P = 0.002). Additionally, the landmark analysis showed that patients with the highest level of TyG had an increased risk of MACEs 6 months after the PCI (P = 0.019).

Conclusion

Elevated TyG index is associated with increased risk of adverse cardiovascular events in patients with ISR, and the extent of increase in the risk is more significant in male patients with diabetes.

Keywords:

• triglyceride–glucose index
• percutaneous coronary intervention
• in-stent restenosis

Data Sharing Statement

Applicants could apply by visiting the official website of the hospital and accessing relevant data after approval by the committee.

Ethics Approval and Consent to Participate

The Ethics Review Committee of Nanjing First Hospital approved this study. As a retrospective study, follow-up was conducted through telephone, letters or rehospitalization, with verbal consent from the ethics committee.

Acknowledgments

Yi-fei Wang and Xiao-han Kong are co-first authors for this study. Huimin Tao and Li Tao shared a second authorship. This paper has been updated to a preprint server as a preprint. Link: https://www.researchgate.net/publication/377642728).

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

There is no funding to report.