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Association Between TyG-BMI Index And Major Adverse Cardiac And Cerebrovascular Events In Patients Undergoing Percutaneous Coronary Intervention

Posted on:2024-09-19Degree:MasterType:Thesis
Country:ChinaCandidate:Y ChengFull Text:PDF
GTID:2544306932970759Subject:Internal medicine
Abstract/Summary:PDF Full Text Request
Objective:To analyze the connection between triglyceride glucose-body mass index(Ty G-BMI index)and major adverse cardiac and cerebrovascular events(MACCEs)in patients with coronary artery disease(CAD)undergoing percutaneous coronary intervention(PCI)and drug-eluting stent(DES)implantation,and to assess the predictive power of Ty G-BMI index for MACCEs.Methods:Between July 2009 and August 2011,a total of 2533 consecutive study participants were diagnosed with CAD and underwent PCI with DES implantation at the Zhengzhou University’s First Affiliated Hospital.Antiplatelet treatment and lipid control were routinely administered according to the current guidelines.The median duration of follow-up for all patients was 29.8 months.Data from 1438 patients was analyzed in the study.MACCEs,defined as a composite of acute myocardial infarction,repeat revascularization,stroke,and all-cause death,were the clinical outcomes.All participants were separated into tertiles according to the Ty G-BMI index levels and the characteristics were depicted.Logistic analyses,subgroup analyses and restricted cubic splines(RCS)were performed to investigate the relationship between Ty G-BMI and MACCEs.The receiver operating characteristic(ROC)curves,net reclassification improvement(NRI),and integrated discrimination improvement(IDI)were utilized to determine whether the addition of the Ty G-BMI index enhances the predictive ability of the model containing traditional risk indicators for MACCEs.Results:Present study included 1438 patients with CAD,986 men and 452 women,with a mean age of 60.1 ± 11.1 years.During the follow-up period,195(13.6%)incident patient cases of MACCEs were ascertained.1.Among the included population,the subgroup with higher Ty G-BMI had a greater percentage of women,a history of hypertension,and a history of diabetes,but a lower proportion of patients who smoked(P < 0.05).Patients with higher Ty G-BMI index levels had higher BMI,triglyceride,total cholesterol and low-density lipoprotein cholesterol levels,while the creatinine and high-density lipoprotein cholesterol levels were lower(P< 0.05).Patients with higher levels of Ty G-BMI exhibited a higher proportion of multivessel lesions,a higher incidence of RCA lesions,and a higher number of stents implanted(P < 0.05).2.The incidence of MACCEs showed no statistically significant differences in the Ty G-BMI index tertiles in the analyzed population(P > 0.05).Logistic regression analysis suggested that the association between Ty G-BMI index and MACCEs did not achieve statistical significance(OR = 1.11,95% CI 0.91-1.37,P = 0.304).3.Further exploratory subgroup analysis and multivariable logistic regression analysis revealed the relationship between the Ty G-BMI index(per 1 SD increased)and MACCEs in the elderly patients(OR = 1.22,95% CI 1.011-1.467,P = 0.038)and in the female patients(OR = 1.33,95% CI 1.004-1.764,P = 0.047).Restricted cubic splines were fitted and showed the linear correlation between Ty G-BMI index and MACCEs in elderly and female patients.4.The incremental effect of adding Ty G-BMI index to the model based on traditional risk factors for MACCEs was evaluated.Area under the curve(AUC),NRI and IDI were compared in elderly and female patients,respectively,and the results suggested that the addition of Ty G-BMI index did not improve the risk prediction for MACCEs over traditional risk factors.Conclusions:1.The Ty G-BMI index was substantially linked with MACCEs in the elderly patients and female patients;2.Higher Ty G-BMI index was linearly related to higher risk of MACCEs in the elderly patients and in the female patients;3.The inclusion of Ty G-BMI index did not provide better predictive performance for MACCEs in the elderly and female patients.
Keywords/Search Tags:Triglyceride glucose-body mass index, Insulin resistance, Major adverse cardiac and cerebrovascular events, Coronary artery disease, Percutaneous coronary intervention
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