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Published on: May 28, 2019
Triglyceride-Glucose Index and New-Onset Atrial Fibrillation in ST-Segment Elevation Myocardial Infarction Patients
Yang Ling1, Cong Fu1, Qun Fan1
1Department of Cardiology, Yijishan Hospital, Wannan Medical College, Wuhu, China.
Insights
The triglyceride-glucose (TyG) index predicts new-onset atrial fibrillation (NOAF) in ST-segment elevation myocardial infarction (STEMI) patients post-percutaneous coronary intervention (PCI). Higher TyG index indicates poorer prognosis and increased long-term mortality risk.
Area of Science:
- Cardiology
- Metabolic Syndrome
- Clinical Research
Background:
- New-onset atrial fibrillation (NOAF) worsens outcomes in ST-segment elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention (PCI).
- The triglyceride-glucose (TyG) index, a marker of insulin resistance, shows prognostic value in STEMI patients.
- The association between TyG index and NOAF in STEMI patients post-PCI remains unestablished.
Purpose of the Study:
- To evaluate the triglyceride-glucose (TyG) index as a predictor of new-onset atrial fibrillation (NOAF) incidence in STEMI patients undergoing PCI.
- To examine the relationship between NOAF and long-term all-cause mortality in this patient cohort.
- To establish the clinical utility of the TyG index in risk stratification for STEMI patients.
Main Methods:
- Retrospective cohort study including 549 STEMI patients who underwent PCI.
- Patients were categorized into NOAF and sinus rhythm (SR) groups.
- Logistic regression, ROC curve analysis, and Kaplan-Meier curves were used to assess TyG index predictive value and mortality differences.
Main Results:
- NOAF occurred in 7.7% of STEMI patients post-PCI.
- The TyG index independently predicted NOAF (OR: 8.884, P=0.014) with significant predictive value (AUC: 0.758, P<0.001).
- NOAF patients exhibited higher long-term all-cause mortality rates compared to SR patients (log-rank P=0.002) over a median 35-month follow-up.
Conclusions:
- The TyG index is an independent predictor of NOAF during hospitalization in STEMI patients post-PCI.
- Elevated TyG index is associated with a poorer long-term prognosis, including increased all-cause mortality.
- The TyG index can aid in identifying high-risk STEMI patients for NOAF and adverse outcomes.
Background:
New-onset atrial fibrillation (NOAF) is associated with worse prognostic outcomes in cases diagnosed with ST-segment elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention (PCI). The triglyceride-glucose (TyG) index, as a credible and convenient marker of insulin resistance, has been shown to be predictive of outcomes for STEMI patients following revascularization. The association between TyG index and NOAF among STEMI patients following PCI, however, has not been established to date.
Objective:
To assess the utility of the TyG index as a predictor of NOAF incidence in STEMI patients following PCI, and to assess the relationship between NOAF and long-term all-cause mortality.
Methods:
This retrospective cohort research enrolled 549 STEMI patients that had undergone PCI, with these patients being clustered into the NOAF group and sinus rhythm (SR) group. The predictive relevance of TyG index was evaluated through logistic regression analyses and the receiver operating characteristic (ROC) curve. Kaplan-Meier curve was employed to explore differences in the long-term all-cause mortality between the NOAF and SR group.
Results:
NOAF occurred in 7.7% of the enrolled STEMI patients after PCI. After multivariate logistic regression analysis, the TyG index was found to be an independent predictor of NOAF [odds ratio (OR): 8.884, 95% confidence interval (CI): 1.570-50.265, P = 0.014], with ROC curve analyses further supporting the predictive value of this parameter, which exhibited an area under ROC curve of 0.758 (95% CI: 0.720-0.793, P < 0.001). All-cause mortality rates were greater for patients in the NOAF group in comparison with the SR group over a median 35-month follow-up period (log-rank P = 0.002).
Conclusions:
The TyG index exhibits values as an independent predictor of NOAF during hospitalization, which indicated a poorer prognosis after a relatively long-term follow-up.
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