Association between triglyceride–glucose index and mortality in critically ill patients with atrial fibrillation: a retrospective cohort study
Abstract Background The triglyceride–glucose (TyG) index, an emerging surrogate marker of insulin resistance, has been implicated in adverse cardiovascular outcomes. However, its prognostic value in critically ill patients with atrial fibrillation (AF) remains unclear. This study aimed to investigat...
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BMC
2025-03-01
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| Series: | Cardiovascular Diabetology |
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| Online Access: | https://doi.org/10.1186/s12933-025-02697-6 |
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| author | Rong Ding Erjing Cheng Miao Wei Liya Pan Lu Ye Yi Han Xuan Zhang Chao Xue Jiannan Gong Hui Zhao |
| author_facet | Rong Ding Erjing Cheng Miao Wei Liya Pan Lu Ye Yi Han Xuan Zhang Chao Xue Jiannan Gong Hui Zhao |
| author_sort | Rong Ding |
| collection | DOAJ |
| description | Abstract Background The triglyceride–glucose (TyG) index, an emerging surrogate marker of insulin resistance, has been implicated in adverse cardiovascular outcomes. However, its prognostic value in critically ill patients with atrial fibrillation (AF) remains unclear. This study aimed to investigate the association between the TyG index and all-cause mortality in this high-risk population. Methods We identified critically ill patients with AF from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and categorized them into tertiles based on their TyG index levels. The primary outcome was 30-day mortality, with 90-day and 365-day all-cause mortality as secondary outcomes. Cox proportional hazards regression analysis and restricted cubic splines were used to elucidate the relationship between the TyG index and all-cause mortality. Kaplan–Meier survival analysis was performed to visualize survival differences among the tertiles. Results A total of 1473 patients were included; the 30-day, 90-day, and 365-day all-cause mortality rates were 26.8%, 33.3%, and 41.1%, respectively. Multivariate Cox proportional hazards analysis revealed that the TyG index was independently associated with mortality at 30 days [hazard ratio (HR) (95% confidence interval (CI)) 1.26 (1.09–1.45), P = 0.002], 90 days [HR (95% CI) 1.27 (1.11–1.45), P < 0.001], and 365 days [HR (95% CI) 1.24 (1.10–1.40), P < 0.001]. Restricted cubic splines regression showed a positive linear association between the TyG index and mortality risk. Kaplan–Meier survival curves further confirmed the significant survival disparities across TyG index tertiles. Conclusions A significant linear association was observed between higher TyG index and increased all-cause mortality at 30, 90, and 365 days in critically ill patients with AF. This underscores the role of the TyG index as a key prognostic indicator for risk stratification and management in intensive care. |
| format | Article |
| id | doaj-art-5aeaeb9501834209b7ed1f4585300a4b |
| institution | Kabale University |
| issn | 1475-2840 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj-art-5aeaeb9501834209b7ed1f4585300a4b2025-08-20T03:45:11ZengBMCCardiovascular Diabetology1475-28402025-03-0124111010.1186/s12933-025-02697-6Association between triglyceride–glucose index and mortality in critically ill patients with atrial fibrillation: a retrospective cohort studyRong Ding0Erjing Cheng1Miao Wei2Liya Pan3Lu Ye4Yi Han5Xuan Zhang6Chao Xue7Jiannan Gong8Hui Zhao9Department of Respiratory Intensive Care Unit, Second Hospital of Shanxi Medical UniversityDepartment of Pulmonary and Critical Care Medicine, Second Hospital of Shanxi Medical UniversityDepartment of Intensive Care Unit, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical UniversityDepartment of Cardiology, The Second Affiliated Hospital, Yuying Children’s Hospital of Wenzhou Medical UniversityDepartment of Pulmonary and Critical Care Medicine, Second Hospital of Shanxi Medical UniversityDepartment of Respiratory Intensive Care Unit, Second Hospital of Shanxi Medical UniversityDepartment of Respiratory Intensive Care Unit, Second Hospital of Shanxi Medical UniversityDepartment of Respiratory Intensive Care Unit, Second Hospital of Shanxi Medical UniversityDepartment of Pulmonary and Critical Care Medicine, Second Hospital of Shanxi Medical UniversityDepartment of Pulmonary and Critical Care Medicine, Second Hospital of Shanxi Medical UniversityAbstract Background The triglyceride–glucose (TyG) index, an emerging surrogate marker of insulin resistance, has been implicated in adverse cardiovascular outcomes. However, its prognostic value in critically ill patients with atrial fibrillation (AF) remains unclear. This study aimed to investigate the association between the TyG index and all-cause mortality in this high-risk population. Methods We identified critically ill patients with AF from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and categorized them into tertiles based on their TyG index levels. The primary outcome was 30-day mortality, with 90-day and 365-day all-cause mortality as secondary outcomes. Cox proportional hazards regression analysis and restricted cubic splines were used to elucidate the relationship between the TyG index and all-cause mortality. Kaplan–Meier survival analysis was performed to visualize survival differences among the tertiles. Results A total of 1473 patients were included; the 30-day, 90-day, and 365-day all-cause mortality rates were 26.8%, 33.3%, and 41.1%, respectively. Multivariate Cox proportional hazards analysis revealed that the TyG index was independently associated with mortality at 30 days [hazard ratio (HR) (95% confidence interval (CI)) 1.26 (1.09–1.45), P = 0.002], 90 days [HR (95% CI) 1.27 (1.11–1.45), P < 0.001], and 365 days [HR (95% CI) 1.24 (1.10–1.40), P < 0.001]. Restricted cubic splines regression showed a positive linear association between the TyG index and mortality risk. Kaplan–Meier survival curves further confirmed the significant survival disparities across TyG index tertiles. Conclusions A significant linear association was observed between higher TyG index and increased all-cause mortality at 30, 90, and 365 days in critically ill patients with AF. This underscores the role of the TyG index as a key prognostic indicator for risk stratification and management in intensive care.https://doi.org/10.1186/s12933-025-02697-6Triglyceride–glucose indexAtrial fibrillationInsulin resistanceAll-cause mortalityMIMIC- IV database |
| spellingShingle | Rong Ding Erjing Cheng Miao Wei Liya Pan Lu Ye Yi Han Xuan Zhang Chao Xue Jiannan Gong Hui Zhao Association between triglyceride–glucose index and mortality in critically ill patients with atrial fibrillation: a retrospective cohort study Cardiovascular Diabetology Triglyceride–glucose index Atrial fibrillation Insulin resistance All-cause mortality MIMIC- IV database |
| title | Association between triglyceride–glucose index and mortality in critically ill patients with atrial fibrillation: a retrospective cohort study |
| title_full | Association between triglyceride–glucose index and mortality in critically ill patients with atrial fibrillation: a retrospective cohort study |
| title_fullStr | Association between triglyceride–glucose index and mortality in critically ill patients with atrial fibrillation: a retrospective cohort study |
| title_full_unstemmed | Association between triglyceride–glucose index and mortality in critically ill patients with atrial fibrillation: a retrospective cohort study |
| title_short | Association between triglyceride–glucose index and mortality in critically ill patients with atrial fibrillation: a retrospective cohort study |
| title_sort | association between triglyceride glucose index and mortality in critically ill patients with atrial fibrillation a retrospective cohort study |
| topic | Triglyceride–glucose index Atrial fibrillation Insulin resistance All-cause mortality MIMIC- IV database |
| url | https://doi.org/10.1186/s12933-025-02697-6 |
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