BACKGROUND Insulin resistance (IR) is considered a pivotal risk factor for cardiometabolic diseases, and the triglyceride-glucose index (TyG index) has emerged as a reliable surrogate marker of IR. Although several recent studies have shown the association of the TyG index with vascular disease, no studies have further investigated the role of the TyG index in acute ST-elevation myocardial infarction (STEMI). The objective of the present study was to evaluate the potential role of the TyG index as a predictor of prognosis in STEMI patients after percutaneous coronary intervention (PCI). METHODS The study included 1092 STEMI patients who underwent PCI. The patients were divided into 4 quartiles according to TyG index levels. Clinical characteristics, fasting plasma glucose (FPG), triglycerides (TGs), other biochemical parameters, and the incidence of major adverse cardiovascular and cerebral events (MACCEs) during the follow-up period were recorded. The TyG index was calculated using the following formula: ln[fasting TGs (mg/dL) × FPG (mg/dL)/2]. RESULTS The incidence of MACCEs and all-cause mortality within 30 days, 6 months and 1 year after PCI were higher among STEMI patients with TyG index levels in the highest quartile. The TyG index was significantly associated with an increased risk of MACCEs in STEMI patients within 1 year after PCI, independent of confounding factors, with a value of 1.529 (95% CI 1.001-2.061; P = 0.003) for those in the highest quartile. The area under the curve (AUC) of the TyG index predicting the occurrence of MACCEs in STEMI patients after PCI was 0.685 (95% CI 0.610-0.761; P = 0.001). The results also revealed that Killip class > 1, anaemia, albumin, uric acid, number of stents and left ventricular ejection fraction (LVEF) were independent predictors of MACCEs in STEMI patients after PCI (all P < 0.05). CONCLUSIONS This study indicated an association between higher TyG index levels and increased risk of MACCEs in STEMI patients for the first time, and the TyG index might be a valid predictor of clinical outcomes in STEMI patients undergoing PCI. Trial Registration ChiCTR1900024577.

中文翻译：

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高甘油三酸酯-葡萄糖指数与经皮冠状动脉介入治疗后急性ST段抬高型心肌梗死患者预后不良有关。

背景技术胰岛素抵抗（IR）被认为是心脏代谢疾病的关键危险因素，甘油三酯-葡萄糖指数（TyG指数）已成为IR的可靠替代指标。尽管最近的一些研究表明TyG指数与血管疾病的相关性，但尚无研究进一步研究TyG指数在急性ST抬高型心肌梗死（STEMI）中的作用。本研究的目的是评估经皮冠状动脉介入治疗（PCI）后，TyG指数作为STEMI患者预后的预测指标的潜在作用。方法该研究包括1092例行PCI的STEMI患者。根据TyG指数水平将患者分为4个四分位数。临床特征，空腹血糖（FPG），甘油三酸酯（TGs），其他生化参数，并记录随访期间主要不良心血管和脑事件（MACCE）的发生率。使用以下公式计算TyG指数：ln [空腹TG（mg / dL）×FPG（mg / dL）/ 2]。结果在最高四分位数中，TyG指数水平较高的STEMI患者中，PCI后30天，6个月和1年内MACCE的发生率和全因死亡率较高。与混杂因素无关，TyG指数与PCI后1年内STEMI患者MACCE发生风险增加显着相关，四分位数最高者的值为1.529（95％CI 1.001-2.061； P = 0.003）。预测PCI后STEMI患者发生MACCE的TyG指数的曲线下面积（AUC）为0.685（95％CI 0.610-0.761； P = 0.001）。结果还显示Killip类别> 1 贫血，白蛋白，尿酸，支架数量和左心室射血分数（LVEF）是PCI术后STEMI患者MACCE的独立预测因子（所有P <0.05）。结论这项研究首次表明STEMI患者中较高的TyG指数水平与MACCE风险增加之间存在关联，并且TyG指数可能是接受PCI的STEMI患者临床预后的有效预测指标。试用注册ChiCTR1900024577。TyG指数可能是接受PCI的STEMI患者临床预后的有效预测指标。试用注册ChiCTR1900024577。TyG指数可能是接受PCI的STEMI患者临床预后的有效预测指标。试用注册ChiCTR1900024577。