Predictive Value Of TyG Index For Adverse Cardiovascular Events In Patients With ST-Segment Elevation Myocardial Infarction After PCI In Hospital

Objectives To investigate the predictive value of triglyceride-glucose(TyG)index in predicting major cardiovascular adverse events after PCI in patients with ST-segment elevation myocardial infarction(STEMI).Methods A total of 464 STEMI patients who received primary percutaneous cornary intervention(p PCI)in The Department of Cardiology,Hebei General Hospital from August 2016 to July 2019 were selected.According to the TyG index level at admission,464 patients were divided into the high TyG index group and the low TyG index group according to the median.The baseline data,clinical and imaging characteristics and major adverse cardiovascular events(MACE)in the hospital of the two groups were analyzed.Speraman correlation analysis was used to analyze the correlation between TyG index and the degree of coronary artery disease and MACE in hospital.A logistic regression model was constructed with in-hospital MACE as the primary endpoint,and receiver operating characteristic(ROC)curve was drawn to explore the predictive value of TyG index for inhospital MACE in STEMI patients after p PCI.Results 47 cases(20.3%)of MACE occurred in the TyG high level group,which was significantly higher than that in the TyG low level group(12.5%),and the nosocomial mortality(5.2%)and incidence of acute heart failure(18.1%)were both significantly higher than those in the TyG low level group(0.9%,8.2%).Univariate logistic regression analysis showed male(OR=0.435,95%CI: 0.255-0.741,P=0.002),age(OR=1.047,95%CI:1.025-1.069,P<0.001),history of coronary heart disease(OR=1.859,95%CI: 1.032-3.348,P=0.039),diabetes history(OR=2.056,95%CI: 1.211-3.491,P=0.008),heart rate(OR=1.027,95%CI: 1.013-1.041,P<0.001),systolic blood pressure(OR=0.980,95%CI:0.969-0.991,P<0.001),diastolic blood pressure(OR=0.960,95%CI: 0.943-0.977,P<0.001),LVEF(OR=0.917,95%CI: 0.892-0.943,P<0.001),anterior wall myocardial infarction(OR=3.279,95%CI: 1.649-6.522,P=0.001),multi-vessel lesions(OR=2.217,95%CI: 1.077-4.562,P=0.031),no reflow or slow refolw(OR=3.373,95%CI: 1.969-5.779,P<0.001),intraoperative reperfusion arrhythmia(OR=1.932,95%CI: 1.160-3.218,P=0.011),albumin(OR=0.895,95%CI: 0.836-0.957,P=0.001),creatinine(OR=1.012,95%CI: 1.003-1.022,P=0.007),TyG index(OR=1.708,95%CI: 1.058-2.759,P=0.029)were the influencing factors of MACE in hospital after PCI in STEMI patients.Multivariate logistic regression analysis showed that male(OR=0.460,95%CI: 0.214-0.986,P=0.046),heart rate(OR=1.030,95%CI: 1.013-1.047,P=0.001),diastolic blood pressure(OR=0.937,95%CI: 0.903-0.973,P=0.001),LVEF(OR=0.941,95%CI: 0.910-0.974,P<0.001),anterior wall myocardial infarction(OR=3.742,95%CI: 1.835-7.630,P<0.001),multi-vessel disease(OR=2.127,95%CI: 1.019-4.442,P=0.045),intraoperative reperfusion arrhythmia(OR=2.832,95%CI: 1.469-5.459,P=0.002),creatinine(OR=1.014,95%CI: 1.005-1.023,P=0.002)and TyG index(OR=1.734,95%CI: 1.073-2.803,P=0.025)were independent influencing factors for the occurrence of MACE in hospital after PCI in STEMI patients.The results of receiver operating characteristic(ROC)curve of TyG index showed that the sensitivity and specificity of TyG index in predicting the inhospital MACE after PCI in STEMI patients were 53.9% and 67.5%,the area under the curve(AUC)was0.603(95%CI: 0.531-0.675,P=0.004),and the optimal cut-off value was 9.11.Recombinant human brain natriuretic peptide(22.8%vs.10.3%,P<0.001)and aldosterone receptor antagonists(89.7%vs.82.3%,P=0.023)were more used in patients with high TyG index.Conclusions 1 TyG index has certain predictive value for MACE in hospital after PCI in STEMI patients;2 TyG index was positively correlated with multi-vessel lesions,SYNTAX score and MACE in hospital.3 Heart rate,diastolic blood pressure,LVEF,anterior wall myocardial infarction,intraoperative reperfusion arrhythmia,multi-vessel lesions,creatinine and TyG index were independent influencing factors for the MACE in STEMI patients after PCI in hospital.Heart rate,anterior wall myocardial infarction,intraoperative reperfusion arrhythmia,multivessel lesions,creatinine and TyG index were independent risk factors for MACE after PCI in STEMI patients.Figure 2;Table 8;Reference 175...