Association between triglyceride glucose index and adverse cardiovascular prognosis in patients with atrial fibrillation without diabetes: a retrospective cohort study

Abstract Background Atrial fibrillation (AF) is the most prevalent arrhythmia encountered in clinical practice. Triglyceride glucose index (Tyg), a convenient evaluation variable for insulin resistance, has shown associations with adverse cardiovascular outcomes. However, studies on the Tyg index’s...

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Main Authors: Aobo Gong, Ying Cao, Zexi Li, Wentao Li, Fanghui Li, Yao Tong, Xianjin Hu, Rui Zeng
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Lipids in Health and Disease
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Online Access:https://doi.org/10.1186/s12944-025-02447-3
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author Aobo Gong
Ying Cao
Zexi Li
Wentao Li
Fanghui Li
Yao Tong
Xianjin Hu
Rui Zeng
author_facet Aobo Gong
Ying Cao
Zexi Li
Wentao Li
Fanghui Li
Yao Tong
Xianjin Hu
Rui Zeng
author_sort Aobo Gong
collection DOAJ
description Abstract Background Atrial fibrillation (AF) is the most prevalent arrhythmia encountered in clinical practice. Triglyceride glucose index (Tyg), a convenient evaluation variable for insulin resistance, has shown associations with adverse cardiovascular outcomes. However, studies on the Tyg index’s predictive value for adverse prognosis in patients with AF without diabetes are lacking. Methods This retrospective study utilized electronic medical records to collect data on patients with AF hospitalized at West China Hospital from January to June 2020. Participants were categorized into three groups based on their Tyg index levels. The primary outcome, major adverse cardiovascular events, included cardiac death, stroke, and myocardial infarction. Kaplan–Meier curve, Cox proportional hazards regression model, and restricted cubic spline were employed to explore the relationship between the Tyg index and outcomes. The predictive performance of the CHA2DS2-VASc model was evaluated after incorporating the Tyg index. Results The study comprised 864 participants (mean age 67.69 years, 55.32% male, 57.52% paroxysmal AF). Patients with high Tyg index had a significantly higher risk of developing major adverse cardiovascular events (MACE) (P < 0.001, hazard ratio: 2.05, 95% confidence interval:1.65–2.56). The MACE risk in the middle Tyg group was similar to that in the low Tyg group (P = 0.1) during the 48-month follow-up period. However, focusing on the last 24 months revealed a higher MACE risk (P = 0.015) in the middle Tyg group. The restricted cubic spline analysis revealed an S-shaped correlation between Tyg and MACE. The CHA2DS2-VASc model combined with the Tyg index showed improved predictive performance and net benefit. Conclusions A high Tyg index is associated with poorer prognosis in patients with AF without diabetes. Integrating the Tyg index into the CHA2DS2-VASc model may enhance its predictive performance, offering clinical utility.
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spelling doaj-art-4cff16abba4b44d894eb995d670f324e2025-01-26T12:50:33ZengBMCLipids in Health and Disease1476-511X2025-01-0124111310.1186/s12944-025-02447-3Association between triglyceride glucose index and adverse cardiovascular prognosis in patients with atrial fibrillation without diabetes: a retrospective cohort studyAobo Gong0Ying Cao1Zexi Li2Wentao Li3Fanghui Li4Yao Tong5Xianjin Hu6Rui Zeng7Department of Cardiology, West China Hospital, Sichuan University West China School of MedicineDepartment of Cardiology, West China Hospital, Sichuan University West China School of MedicineDepartment of Cardiology, West China Hospital, Sichuan University West China School of MedicineDepartment of Cardiology, West China Hospital, Sichuan University West China School of MedicineDepartment of Cardiology, West China Hospital, Sichuan University West China School of MedicineDepartment of Cardiology, West China Hospital, Sichuan University West China School of MedicineDepartment of Cardiology, West China Hospital, Sichuan University West China School of MedicineDepartment of Cardiology, West China Hospital, Sichuan University West China School of MedicineAbstract Background Atrial fibrillation (AF) is the most prevalent arrhythmia encountered in clinical practice. Triglyceride glucose index (Tyg), a convenient evaluation variable for insulin resistance, has shown associations with adverse cardiovascular outcomes. However, studies on the Tyg index’s predictive value for adverse prognosis in patients with AF without diabetes are lacking. Methods This retrospective study utilized electronic medical records to collect data on patients with AF hospitalized at West China Hospital from January to June 2020. Participants were categorized into three groups based on their Tyg index levels. The primary outcome, major adverse cardiovascular events, included cardiac death, stroke, and myocardial infarction. Kaplan–Meier curve, Cox proportional hazards regression model, and restricted cubic spline were employed to explore the relationship between the Tyg index and outcomes. The predictive performance of the CHA2DS2-VASc model was evaluated after incorporating the Tyg index. Results The study comprised 864 participants (mean age 67.69 years, 55.32% male, 57.52% paroxysmal AF). Patients with high Tyg index had a significantly higher risk of developing major adverse cardiovascular events (MACE) (P < 0.001, hazard ratio: 2.05, 95% confidence interval:1.65–2.56). The MACE risk in the middle Tyg group was similar to that in the low Tyg group (P = 0.1) during the 48-month follow-up period. However, focusing on the last 24 months revealed a higher MACE risk (P = 0.015) in the middle Tyg group. The restricted cubic spline analysis revealed an S-shaped correlation between Tyg and MACE. The CHA2DS2-VASc model combined with the Tyg index showed improved predictive performance and net benefit. Conclusions A high Tyg index is associated with poorer prognosis in patients with AF without diabetes. Integrating the Tyg index into the CHA2DS2-VASc model may enhance its predictive performance, offering clinical utility.https://doi.org/10.1186/s12944-025-02447-3Atrial fibrillationTriglyceride glucose indexMajor adverse cardiovascular eventsRisk predictionClinical prognosis
spellingShingle Aobo Gong
Ying Cao
Zexi Li
Wentao Li
Fanghui Li
Yao Tong
Xianjin Hu
Rui Zeng
Association between triglyceride glucose index and adverse cardiovascular prognosis in patients with atrial fibrillation without diabetes: a retrospective cohort study
Lipids in Health and Disease
Atrial fibrillation
Triglyceride glucose index
Major adverse cardiovascular events
Risk prediction
Clinical prognosis
title Association between triglyceride glucose index and adverse cardiovascular prognosis in patients with atrial fibrillation without diabetes: a retrospective cohort study
title_full Association between triglyceride glucose index and adverse cardiovascular prognosis in patients with atrial fibrillation without diabetes: a retrospective cohort study
title_fullStr Association between triglyceride glucose index and adverse cardiovascular prognosis in patients with atrial fibrillation without diabetes: a retrospective cohort study
title_full_unstemmed Association between triglyceride glucose index and adverse cardiovascular prognosis in patients with atrial fibrillation without diabetes: a retrospective cohort study
title_short Association between triglyceride glucose index and adverse cardiovascular prognosis in patients with atrial fibrillation without diabetes: a retrospective cohort study
title_sort association between triglyceride glucose index and adverse cardiovascular prognosis in patients with atrial fibrillation without diabetes a retrospective cohort study
topic Atrial fibrillation
Triglyceride glucose index
Major adverse cardiovascular events
Risk prediction
Clinical prognosis
url https://doi.org/10.1186/s12944-025-02447-3
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