Triglyceride-glucose index is associated with severe obstructive coronary artery disease and atherosclerotic target lesion failure among young adults
Abstract Background Early diagnosis and treatment effectiveness of early-onset coronary artery disease (EOCAD) are crucial, and non-invasive predictive biomarkers are needed for young adults. We aimed to evaluate the usefulness of the triglyceride-glucose (TyG) index, a novel marker of insulin resis...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-023-02004-1 |
| _version_ | 1797454014806228992 |
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| author | Shalaimaiti Shali Lingfeng Luo Kang Yao Xiangdong Sun Hongyi Wu Shuning Zhang Lili Xu Wei Gao Jianxuan Li Juying Qian Yan Zheng Yuxiang Dai Junbo Ge the GRAND investigators |
| author_facet | Shalaimaiti Shali Lingfeng Luo Kang Yao Xiangdong Sun Hongyi Wu Shuning Zhang Lili Xu Wei Gao Jianxuan Li Juying Qian Yan Zheng Yuxiang Dai Junbo Ge the GRAND investigators |
| author_sort | Shalaimaiti Shali |
| collection | DOAJ |
| description | Abstract Background Early diagnosis and treatment effectiveness of early-onset coronary artery disease (EOCAD) are crucial, and non-invasive predictive biomarkers are needed for young adults. We aimed to evaluate the usefulness of the triglyceride-glucose (TyG) index, a novel marker of insulin resistance, in identifying young CAD patients and predicting their risk of developing target lesion failure (TLF). Methods We recruited EOCAD patients (luminal narrowing ≥ 70%) and controls free from CAD (luminal narrowing < 30%), both aged 45 years or younger, from 38 hospitals in China between 2017 and 2020. EOCAD patients who underwent successful percutaneous coronary intervention were followed for incident TLF. TyG index was defined as Ln [fasting triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2]. We used logistic regression and Cox proportional hazards modeling to evaluate the association of TyG index with prevalent EOCAD and incident TLF, respectively. The discriminatory ability of TyG index was assessed by the area under the receiver-operating characteristic curve (AUC). Results Among the included 1513 EOCAD patients (39.6 ± 4.4 years, 95.4% male) and 1513 age-matched controls (39.0 ± 4.4 years, 46.4% male), TyG index was positively associated with the prevalence of EOCAD (adjusted odds ratio: 1.40, 95% confidence interval [CI] 1.23–1.60, per standard deviation [SD] increase in TyG index). The addition of TyG index to an empirical risk model provided an improvement in diagnostic ability for EOCAD, with a net reclassification improvement of 0.10 (95% CI 0.03–0.17, p = 0.005). During a medium of 33 month (IQR: 31–34 months) follow-up, 43 (3.3%) patients experienced TLF. Multivariate Cox regression model revealed that TyG index was an independent risk factor for TLF (adjusted hazard ratio [HR]: 2.410, 95% CI 1.07–5.42 comparing the top to bottom TyG index tertile groups; HR: 1.30, 95% CI 1.01–1.73, per SD increase in TyG index). Compared with a model of conventional risk factors alone, the addition of the TyG index modestly improved the AUC (0.722–0.734, p = 0.04) to predict TLF. Conclusions TyG index is positively associated with prevalent EOCAD and incident TLF. TyG index appeared to be a valuable component of future efforts to improve CAD risk stratification and TLF outcome prediction among young adults. |
| first_indexed | 2024-03-09T15:31:09Z |
| format | Article |
| id | doaj.art-58371f666cbc4349ab1f7c08487b5c18 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-03-09T15:31:09Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-58371f666cbc4349ab1f7c08487b5c182023-11-26T12:15:23ZengBMCCardiovascular Diabetology1475-28402023-10-0122111110.1186/s12933-023-02004-1Triglyceride-glucose index is associated with severe obstructive coronary artery disease and atherosclerotic target lesion failure among young adultsShalaimaiti Shali0Lingfeng Luo1Kang Yao2Xiangdong Sun3Hongyi Wu4Shuning Zhang5Lili Xu6Wei Gao7Jianxuan Li8Juying Qian9Yan Zheng10Yuxiang Dai11Junbo Ge12 the GRAND investigatorsDepartment of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan UniversityHuman Phenome Institute, Fudan UniversityDepartment of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan UniversityDepartment of Cardiology, Xinyang Central Hospital, Xinyang Normal UniversityDepartment of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan UniversityDepartment of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan UniversityDepartment of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan UniversityDepartment of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan UniversityDepartment of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan UniversityDepartment of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan UniversityDepartment of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan UniversityDepartment of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan UniversityDepartment of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan UniversityAbstract Background Early diagnosis and treatment effectiveness of early-onset coronary artery disease (EOCAD) are crucial, and non-invasive predictive biomarkers are needed for young adults. We aimed to evaluate the usefulness of the triglyceride-glucose (TyG) index, a novel marker of insulin resistance, in identifying young CAD patients and predicting their risk of developing target lesion failure (TLF). Methods We recruited EOCAD patients (luminal narrowing ≥ 70%) and controls free from CAD (luminal narrowing < 30%), both aged 45 years or younger, from 38 hospitals in China between 2017 and 2020. EOCAD patients who underwent successful percutaneous coronary intervention were followed for incident TLF. TyG index was defined as Ln [fasting triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2]. We used logistic regression and Cox proportional hazards modeling to evaluate the association of TyG index with prevalent EOCAD and incident TLF, respectively. The discriminatory ability of TyG index was assessed by the area under the receiver-operating characteristic curve (AUC). Results Among the included 1513 EOCAD patients (39.6 ± 4.4 years, 95.4% male) and 1513 age-matched controls (39.0 ± 4.4 years, 46.4% male), TyG index was positively associated with the prevalence of EOCAD (adjusted odds ratio: 1.40, 95% confidence interval [CI] 1.23–1.60, per standard deviation [SD] increase in TyG index). The addition of TyG index to an empirical risk model provided an improvement in diagnostic ability for EOCAD, with a net reclassification improvement of 0.10 (95% CI 0.03–0.17, p = 0.005). During a medium of 33 month (IQR: 31–34 months) follow-up, 43 (3.3%) patients experienced TLF. Multivariate Cox regression model revealed that TyG index was an independent risk factor for TLF (adjusted hazard ratio [HR]: 2.410, 95% CI 1.07–5.42 comparing the top to bottom TyG index tertile groups; HR: 1.30, 95% CI 1.01–1.73, per SD increase in TyG index). Compared with a model of conventional risk factors alone, the addition of the TyG index modestly improved the AUC (0.722–0.734, p = 0.04) to predict TLF. Conclusions TyG index is positively associated with prevalent EOCAD and incident TLF. TyG index appeared to be a valuable component of future efforts to improve CAD risk stratification and TLF outcome prediction among young adults.https://doi.org/10.1186/s12933-023-02004-1TyG indexInsulin resistanceCoronary artery diseaseEarly-onsetTarget lesion failure |
| spellingShingle | Shalaimaiti Shali Lingfeng Luo Kang Yao Xiangdong Sun Hongyi Wu Shuning Zhang Lili Xu Wei Gao Jianxuan Li Juying Qian Yan Zheng Yuxiang Dai Junbo Ge the GRAND investigators Triglyceride-glucose index is associated with severe obstructive coronary artery disease and atherosclerotic target lesion failure among young adults Cardiovascular Diabetology TyG index Insulin resistance Coronary artery disease Early-onset Target lesion failure |
| title | Triglyceride-glucose index is associated with severe obstructive coronary artery disease and atherosclerotic target lesion failure among young adults |
| title_full | Triglyceride-glucose index is associated with severe obstructive coronary artery disease and atherosclerotic target lesion failure among young adults |
| title_fullStr | Triglyceride-glucose index is associated with severe obstructive coronary artery disease and atherosclerotic target lesion failure among young adults |
| title_full_unstemmed | Triglyceride-glucose index is associated with severe obstructive coronary artery disease and atherosclerotic target lesion failure among young adults |
| title_short | Triglyceride-glucose index is associated with severe obstructive coronary artery disease and atherosclerotic target lesion failure among young adults |
| title_sort | triglyceride glucose index is associated with severe obstructive coronary artery disease and atherosclerotic target lesion failure among young adults |
| topic | TyG index Insulin resistance Coronary artery disease Early-onset Target lesion failure |
| url | https://doi.org/10.1186/s12933-023-02004-1 |
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