A Combined Measure of the Triglyceride Glucose Index and Trimethylamine N-Oxide in Risk Stratification of ST-Segment...

Area of Science:

• Cardiology
• Biomarkers
• Risk Stratification

Background:

• Elevated triglyceride-glucose (TyG) levels are linked to mortality in coronary artery disease (CAD).
• Trimethylamine N-oxide (TMAO) is associated with atherosclerotic CAD and adverse outcomes.
• The combined prognostic value of TyG and TMAO in optical coherence tomography (OCT)-defined high-risk ST-segment elevation myocardial infarction (STEMI) patients remains unclear.

Purpose of the Study:

• To investigate the incremental prognostic value of combined triglyceride-glucose (TyG) index and trimethylamine N-oxide (TMAO) levels.
• To assess the predictive capability of TyG and TMAO for major adverse cardiovascular events (MACEs) in STEMI patients with high-risk plaque characteristics.

Main Methods:

• A cohort of 274 STEMI patients with pre-intervention OCT imaging was analyzed.
• Patients were assessed for triglyceride-glucose (TyG) index and trimethylamine N-oxide (TMAO) levels.
• Major adverse cardiovascular events (MACEs) were tracked over a median follow-up of 2.027 years.

Main Results:

• Higher TyG and TMAO levels correlated with increased triglycerides, fasting glucose, and diabetes incidence.
• The combination of TMAO > median and TyG ≤ median was significantly associated with higher MACE rates (p=0.009).
• The combined TyG and TMAO model demonstrated good diagnostic value for predicting MACEs (AUC=0.815).

Conclusions:

• Combined TyG index and TMAO measurements enhance risk stratification in STEMI patients with OCT-defined high-risk plaques.
• These biomarkers can aid in identifying patients at higher risk for adverse cardiovascular outcomes.
• The findings support the use of TyG and TMAO as valuable prognostic tools in STEMI management.