Predictive effect of triglyceride-glucose index on No-Reflow Phenomenon in patients with type 2 diabetes mellitus and acute myocardial infarction undergoing primary percutaneous coronary intervention
Abstract Objective Triglyceride glucose (TyG) index is considered as a new alternative marker of insulin resistance and a clinical predictor of type 2 diabetes mellitus (T2DM) combined with coronary artery disease. However, the prognostic value of TyG index on No-Reflow (NR) Phenomenon in T2DM patie...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | Diabetology & Metabolic Syndrome |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13098-024-01306-y |
| _version_ | 1797259139407151104 |
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| author | Juan Ma Mohan Wang Peng Wu Xueping Ma Dapeng Chen Shaobin Jia Ning Yan |
| author_facet | Juan Ma Mohan Wang Peng Wu Xueping Ma Dapeng Chen Shaobin Jia Ning Yan |
| author_sort | Juan Ma |
| collection | DOAJ |
| description | Abstract Objective Triglyceride glucose (TyG) index is considered as a new alternative marker of insulin resistance and a clinical predictor of type 2 diabetes mellitus (T2DM) combined with coronary artery disease. However, the prognostic value of TyG index on No-Reflow (NR) Phenomenon in T2DM patients with acute myocardial infarction (AMI) remains unclear. Methods In this retrospective study, 1683 patients with T2DM and AMI underwent primary percutaneous coronary intervention (PCI) were consecutively included between January 2014 and December 2019. The study population was divided into two groups as follows: Reflow (n = 1277) and No-reflow (n = 406) group. The TyG index was calculated as the ln [fasting triglycerides (mg/dL)×fasting plasma glucose (mg/dL)/2].Multivariable logistic regression models and receiver-operating characteristic curve analysis were conducted to predict the possible risk of no-reflow. Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI) were calculated to determine the ability of the TyG index to contribute to the baseline risk model. Results Multivariable logistic regression models revealed that the TyG index was positively associated with NR[OR,95%CI:5.03,(2.72,9.28),p<0.001] in patients with T2DM and AMI. The area under the curve (AUC) of the TyG index predicting the occurrence of NR was 0.645 (95% CI 0.615–0.673; p < 0.001)], with the cut-off value of 8.98. The addition of TyG index to a baseline risk model had an incremental effect on the predictive value for NR [net reclassification improvement (NRI): 0.077(0.043to 0.111), integrated discrimination improvement (IDI): 0.070 (0.031to 0.108), all p < 0.001]. Conclusions High TyG index was associated with an increased risk of no-reflow after PCI in AMI patients with T2DM. The TyG index may be a valid predictor of NR phenomenon of patients with T2DM and AMI. Early recognition of NR is critical to improve outcomes with AMI and T2DM patients. |
| first_indexed | 2024-04-24T23:04:41Z |
| format | Article |
| id | doaj.art-3d23910de298406f84d27f61c88e3742 |
| institution | Directory Open Access Journal |
| issn | 1758-5996 |
| language | English |
| last_indexed | 2024-04-24T23:04:41Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| spelling | doaj.art-3d23910de298406f84d27f61c88e37422024-03-17T12:33:35ZengBMCDiabetology & Metabolic Syndrome1758-59962024-03-011611910.1186/s13098-024-01306-yPredictive effect of triglyceride-glucose index on No-Reflow Phenomenon in patients with type 2 diabetes mellitus and acute myocardial infarction undergoing primary percutaneous coronary interventionJuan Ma0Mohan Wang1Peng Wu2Xueping Ma3Dapeng Chen4Shaobin Jia5Ning Yan6School of Clinical Medicine, Ningxia Medical UniversitySchool of Clinical Medicine, Ningxia Medical UniversitySchool of Clinical Medicine, Ningxia Medical UniversityHeart Centre, Department of Cardiovascular Diseases, General Hospital of Ningxia Medical UniversityHeart Centre, Department of Cardiovascular Diseases, General Hospital of Ningxia Medical UniversityHeart Centre, Department of Cardiovascular Diseases, General Hospital of Ningxia Medical UniversityHeart Centre, Department of Cardiovascular Diseases, General Hospital of Ningxia Medical UniversityAbstract Objective Triglyceride glucose (TyG) index is considered as a new alternative marker of insulin resistance and a clinical predictor of type 2 diabetes mellitus (T2DM) combined with coronary artery disease. However, the prognostic value of TyG index on No-Reflow (NR) Phenomenon in T2DM patients with acute myocardial infarction (AMI) remains unclear. Methods In this retrospective study, 1683 patients with T2DM and AMI underwent primary percutaneous coronary intervention (PCI) were consecutively included between January 2014 and December 2019. The study population was divided into two groups as follows: Reflow (n = 1277) and No-reflow (n = 406) group. The TyG index was calculated as the ln [fasting triglycerides (mg/dL)×fasting plasma glucose (mg/dL)/2].Multivariable logistic regression models and receiver-operating characteristic curve analysis were conducted to predict the possible risk of no-reflow. Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI) were calculated to determine the ability of the TyG index to contribute to the baseline risk model. Results Multivariable logistic regression models revealed that the TyG index was positively associated with NR[OR,95%CI:5.03,(2.72,9.28),p<0.001] in patients with T2DM and AMI. The area under the curve (AUC) of the TyG index predicting the occurrence of NR was 0.645 (95% CI 0.615–0.673; p < 0.001)], with the cut-off value of 8.98. The addition of TyG index to a baseline risk model had an incremental effect on the predictive value for NR [net reclassification improvement (NRI): 0.077(0.043to 0.111), integrated discrimination improvement (IDI): 0.070 (0.031to 0.108), all p < 0.001]. Conclusions High TyG index was associated with an increased risk of no-reflow after PCI in AMI patients with T2DM. The TyG index may be a valid predictor of NR phenomenon of patients with T2DM and AMI. Early recognition of NR is critical to improve outcomes with AMI and T2DM patients.https://doi.org/10.1186/s13098-024-01306-yTriglyceride-glucose index (TyG index)Type 2 diabetes mellitus (T2DM)Acute myocardial infarction (AMI)No-reflow |
| spellingShingle | Juan Ma Mohan Wang Peng Wu Xueping Ma Dapeng Chen Shaobin Jia Ning Yan Predictive effect of triglyceride-glucose index on No-Reflow Phenomenon in patients with type 2 diabetes mellitus and acute myocardial infarction undergoing primary percutaneous coronary intervention Diabetology & Metabolic Syndrome Triglyceride-glucose index (TyG index) Type 2 diabetes mellitus (T2DM) Acute myocardial infarction (AMI) No-reflow |
| title | Predictive effect of triglyceride-glucose index on No-Reflow Phenomenon in patients with type 2 diabetes mellitus and acute myocardial infarction undergoing primary percutaneous coronary intervention |
| title_full | Predictive effect of triglyceride-glucose index on No-Reflow Phenomenon in patients with type 2 diabetes mellitus and acute myocardial infarction undergoing primary percutaneous coronary intervention |
| title_fullStr | Predictive effect of triglyceride-glucose index on No-Reflow Phenomenon in patients with type 2 diabetes mellitus and acute myocardial infarction undergoing primary percutaneous coronary intervention |
| title_full_unstemmed | Predictive effect of triglyceride-glucose index on No-Reflow Phenomenon in patients with type 2 diabetes mellitus and acute myocardial infarction undergoing primary percutaneous coronary intervention |
| title_short | Predictive effect of triglyceride-glucose index on No-Reflow Phenomenon in patients with type 2 diabetes mellitus and acute myocardial infarction undergoing primary percutaneous coronary intervention |
| title_sort | predictive effect of triglyceride glucose index on no reflow phenomenon in patients with type 2 diabetes mellitus and acute myocardial infarction undergoing primary percutaneous coronary intervention |
| topic | Triglyceride-glucose index (TyG index) Type 2 diabetes mellitus (T2DM) Acute myocardial infarction (AMI) No-reflow |
| url | https://doi.org/10.1186/s13098-024-01306-y |
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