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Prognostic Value of Triglyceride Glucose Index in ST-Elevation Myocardial Infarction: A Key Predictor of Mortality
Murat Bilgin1, Emre Akkaya2, Recep Dokuyucu3
1Department of Cardiology, Private Aktif International Hospital, Yalova 77720, Turkey.
Insights
High triglyceride glucose index (TGI) levels are linked to increased thrombus burden and higher mortality in ST-elevation myocardial infarction (STEMI) patients. TGI aids in predicting STEMI and stratifying patient risk for better treatment planning.
Area of Science:
- Cardiology
- Biochemistry
- Clinical Medicine
Background:
- ST-elevation myocardial infarction (STEMI) is a critical cardiovascular event requiring prompt risk assessment.
- The triglyceride glucose index (TGI) is a novel marker reflecting insulin resistance and metabolic health.
- Understanding TGI's role in STEMI prognosis is crucial for patient management.
Purpose of the Study:
- To investigate the association between the triglyceride glucose index (TGI) and mortality in patients diagnosed with STEMI.
- To evaluate TGI's utility in predicting adverse outcomes following STEMI.
Main Methods:
- Retrospective analysis of STEMI patients who underwent primary percutaneous coronary intervention (PCI) between 2020-2023.
- Patients categorized into low, medium, and high TGI groups based on predefined thresholds.
- Analysis of demographic data, medical history, laboratory results, and clinical outcomes, including mortality.
Main Results:
- Higher TGI levels correlated with increased intracoronary thrombus burden and higher rates of severe thrombosis (TIMI score ≥ 3).
- Significant associations found between high TGI and increased short-term (30-day) and long-term mortality rates.
- TGI emerged as an independent risk factor for both short-term (HR 2.5) and long-term (HR 2.0) mortality in STEMI patients.
Conclusions:
- Elevated TGI levels are significantly associated with increased thrombus burden and mortality in STEMI patients.
- TGI serves as a valuable tool for predicting STEMI, enabling early risk stratification and informing treatment strategies.
- The TGI index offers potential for improved clinical decision-making in the management of STEMI.
Objectives:
We aimed to investigate the association between the triglyceride glucose index (TGI) and mortality in patients with ST-elevation myocardial infarction (STEMI).
Methods:
This retrospective study utilized data from the records of patients diagnosed with STEMI who underwent primary percutaneous coronary intervention (PCI) at the Cardiology Department of Private Aktif International Hospital between 2020 and 2023. Demographic data, medical history, laboratory results, and treatment processes of the patients were obtained from retrospective records. Patients were divided into low (TGI ≤ 8.6)-, medium (TGI = 8.6-9.2)-, and high (TGI ≥ 9.2)-TGI groups according to their TGI levels.
Results:
The average age of the patients was 62 ± 10 years, and 65% were men. The intracoronary thrombus burden of patients in the high-TGI group was found to be significantly higher compared to the low- and medium-TGI groups (p = 0.01). While the rate of patients with a thrombolysis in myocardial infarction (TIMI) thrombosis score of 3 or above was 45% in the high-TGI group, this rate was observed to be 20% in the low-TGI group. The short-term (30-day) mortality rate was found to be 15% in the high-TGI group, 8% in the medium-TGI group, and 5% in the low-TGI group (p = 0.02). Long-term (after 30 days) mortality rates were determined as 25% in the high-TGI group, 15% in the medium-TGI group, and 10% in the low-TGI group (p = 0.01). TGI was an independent risk factor for both short-term and long-term mortality. The hazard ratio (HR) of high TGI levels for short-term mortality was found to be 2.5 (95% CI: 1.5-4.1, p = 0.01), and the HR for long-term mortality was 2.0 (95% CI: 1.3-3.2, p < 0.02).
Conclusions:
Our results show that high TGI levels are associated with increased thrombus burden and high mortality rates in STEMI. TGI can be used not only in predicting STEMI but also in early risk stratification and treatment planning for STEMI patients.
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