Predictive Value Of Triglyceride Glucose Index For Long-term Prognosis Of Patients With Acute Non ST Segment Elevation Myocardial Infarction After Percutaneous Coronary Intervention

Objective:To explore the predictive value of triglyceride glucose product index(tgpi)in the long-term prognosis of patients with acute non ST segment elevation myocardial infarction(NSTEMI)after percutaneous coronary intervention(PCI),so as to provide better treatment strategies for patients with acute NSTEMI,and provide clinical treatment basis for reducing the long-term prognosis of such patients.Method:772 NSTEMI patients who underwent PCI in the first hospital of Jilin University from January 1,2016 to June 30,2018 were enrolled.The inpatient information of these patients was collected through the electronic medical record system.After the inclusion and exclusion criteria,715 eligible patients were selected as the research objects.All patients were followed up for 24 months.First,the patients were divided into four groups according to the quartile of TYG index,and the general clinical characteristics and long-term prognosis of the four groups were compared.Then,the patients were divided into two groups according to whether major adverse cardiovascular and cerebrovascular events(MACCE)occurred.The basic clinical data and disease characteristics of the two groups were compared.ROC curve analysis,Kaplan Meier and Cox regression analysis showed the relationship between TYG index and long-term prognosis of patients with acute non ST segment elevation myocardial infarction after percutaneous coronary intervention.Result:(1)Systolic pressure,hypertension,diabetes,neutrophil ratio,FPG,TG,TC,HDL-C,LDL-C,oral hypoglycemic drugs,insulin,beta blockers were significantly different among the four groups(P < 0.05),while the other indicators were not statistically significant,and the high level of TYG index group systolic pressure,neutrophil ratio,FPG,TG,TC LDL-C was higher,the proportion of hypertension and diabetes was higher,and the proportion of oral hypoglycemic drugs,insulin and beta blockers was higher.(2)Two years after admission,143 patients with NSTEMI developed MACCE(20%);the level of TYG index in patients with MACCE was higher than that in patients without MACCE(P < 0.01);there were 25 cases,29 cases,38 cases and 51 cases of MACCE in the four groups from low to high,and the difference was statistically significant(P = 0.003).(3)Compared with the non MACCE group,the MACCE group had a higher proportion of hypertension,diabetes,myocardial infarction,PCI,smoking and multivessel disease(P < 0.05).There were significant differences in age,systolic blood pressure,BNP,FPG,TC,TG,HDL-C,TYG and EGFR between MACCE group and non MACCE group(P < 0.05).(4)Spearman rank correlation analysis showed that TYG index was positively correlated with systolic blood pressure,heart rate,FPG,TG,TC,LDL-C and Gensini score,while HDL-C and neutrophil ratio were negatively correlated with BMI.(5)Receiver operating characteristic(ROC)curve analysis showed that the cut-off value of TYG for predicting 2-year major adverse cardiovascular events in NSTEMI patients after PCI was 8.899,and the area under the curve was 0.61(95% CI 0.559-0.661;P = 0.001).(6)Kaplan Meier analysis showed that high TYG index group had higher incidence of MACCE(log rank P = 0.001)and recurrent myocardial infarction(log rank P = 0.039).(7)Cox regression showed that TYG index was correlated with MACCE(HR = 1.654,95% CI: 1.355-2.048,P < 0.001).Multivariate analysis further showed that TYG index was an independent predictor of MACCE(HR = 1.476,95% CI: 1.159-1.88,P = 0.002).Conclusion:TYG index is associated with MACCE and is an independent prognostic risk factor for NSTEMI.