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Triglyceride-glucose index's link to cardiovascular outcomes post-percutaneous coronary intervention in China: a
ChangXin Sun1,2, LanQing Hu2, XiaoYa Li2
1Beijing University of Chinese Medicine, Beijing, China.
Insights
The triglyceride-glucose (TyG) index may predict major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI). Higher TyG index levels are associated with increased risks of MACE, mortality, and revascularization.
Area of Science:
- Cardiology
- Metabolic Syndrome Research
Background:
- Percutaneous coronary intervention (PCI) is a standard treatment for myocardial ischemia, yet a notable proportion of patients experience major adverse cardiovascular events (MACE) post-procedure.
- Identifying reliable predictors of MACE is crucial for improving patient outcomes following PCI.
Approach:
- This meta-analysis systematically reviewed studies from Embase, PubMed, Cochrane Library, and Web of Science databases up to March 3, 2023.
- Random-effects models and cluster-robust standard errors were utilized to assess the effect size and establish a dose-response relationship between the triglyceride-glucose (TyG) index and MACE.
- The GRADE Evaluation Scale was employed to evaluate the certainty of the evidence.
Key Points:
- Elevated triglyceride-glucose (TyG) index levels were significantly associated with higher rates of post-PCI MACE.
- A linear relationship was observed between increasing TyG index and the risk of MACE, non-fatal myocardial infarction (MI), and revascularization.
- The TyG index also correlated with an increased risk of all-cause mortality post-PCI.
Conclusions:
- The triglyceride-glucose (TyG) index shows potential as a predictor for major adverse cardiovascular events (MACE), including non-fatal myocardial infarction (MI), revascularization, and all-cause mortality in patients undergoing percutaneous coronary intervention (PCI).
- While the evidence for non-fatal MI is of high certainty, the certainty for MACE, revascularization, and all-cause mortality is low, necessitating further validation.
- A potential linear association between the TyG index and MACE risk post-PCI warrants additional research.
Abstract:
Percutaneous coronary intervention (PCI) addresses myocardial ischaemia, but a significant subset of patients encounter major adverse cardiovascular events (MACE) post-treatment. This meta-analysis investigated the relationship between the post-PCI triglyceride-glucose (TyG) index and MACE. Comprehensive searches of the Embase, PubMed, Cochrane Library, and Web of Science databases were conducted up to 3 March 2023, using relevant keywords. The effect size was determined based on I2 statistic using random-effects models. Cluster-robust standard errors crafted the dose-response curve, and the GRADE Evaluation Scale was employed to rate the quality of evidence. The group with the highest TyG index had significantly higher post-PCI MACE rates than the lowest index group, with hazard ratios (HRs) of 2.04 (95% CI 1.65-2.52; I2 = 77%). Each unit increase in TyG index corresponded to HRs of 1.82 for MACE (95% CI 1.34-2.46; I2 = 92%), 2.57 for non-fatal MI (95% CI 1.49-4.41; I2 = 63%), and 2.06 for revascularization (95% CI 1.23-3.50; I2 = 90%). A linear relationship between TyG index and MACE risk was established (R2 = 0.6114). For all-cause mortality, the HR was 1.93 (95% CI 1.35-2.75; I2 = 50%), indicating a higher mortality risk with elevated TyG index. The GRADE assessment yielded high certainty for non-fatal MI but low certainty for all-cause mortality, revascularization, and MACE. The TyG index may predict risks of post-PCI MACE, all-cause mortality, non-fatal MI, and revascularization, with varied levels of certainty. A potential linear association between the TyG index and MACE post-PCI was identified. Future research should validate these findings.
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