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Wang Y, Wang Y, Sun S, Liu X, Zhao W, Li W, Suo M, Wu Z, Wu X. Triglyceride-glucose index level and variability and outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention: an observational cohort study. Lipids Health Dis 2022; 21:134. [PMID: 36482415 PMCID: PMC9733246 DOI: 10.1186/s12944-022-01731-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 11/03/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The associations between the long-term triglyceride-glucose (TyG) index level and variability and clinical outcomes in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) have not been well studied. METHODS A total of 1,694 ACS patients with at least three postbaseline TyG index measurements within 2 years after PCI were included in the present study. The TyG index was defined as ln (fasting triglycerides [mg/dL] × fasting plasma glucose [mg/dL]/2). Multivariable-adjusted Cox proportional hazard models were used to examine the association between baseline and mean TyG index levels and TyG index variability and the risk of major adverse cardiovascular and cerebrovascular events (MACCEs). RESULTS During the median follow-up of 31 months, the overall incidence of MACCE was 5.9%. Both high baseline and mean TyG index levels were independently associated with an increased risk of MACCEs after adjustment for multiple potential confounders (hazard ratio [HR) 1.76 95% confidence interval [CI] 1.06-2.93; and HR 2.73 95% CI 1.57-4.74). Similarly, higher TyG index variability by successive variation (SD) was well related to a higher prevalence of MACCEs (HR 2.17 95% CI 1.28-3.68). In addition, the mean TyG index level showed a stronger risk prediction for MACCEs than the baseline TyG index level and TyG index-SD (AUCs 0.618 vs 0.566 vs 0.566). CONCLUSIONS The risk of MACCEs significantly increased with higher baseline and mean TyG index levels, as well as TyG index variability, in patients with ACS undergoing PCI. In particular, the mean TyG index level exhibited the highest predicting ability for MACCEs. Therefore, monitoring the long-term pattern of the TyG index deserves attention in clinical practice.
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Affiliation(s)
- Yue Wang
- grid.411606.40000 0004 1761 5917Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029 China
| | - Yue Wang
- grid.411606.40000 0004 1761 5917Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029 China
| | - Shuaifeng Sun
- grid.411606.40000 0004 1761 5917Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029 China
| | - Xinyan Liu
- grid.411606.40000 0004 1761 5917Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029 China
| | - Wenxin Zhao
- grid.411606.40000 0004 1761 5917Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029 China
| | - Wenzheng Li
- grid.411606.40000 0004 1761 5917Center for Coronary Artery Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029 China
| | - Min Suo
- grid.411606.40000 0004 1761 5917Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029 China
| | - Zheng Wu
- grid.411606.40000 0004 1761 5917Center for Coronary Artery Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029 China
| | - Xiaofan Wu
- grid.411606.40000 0004 1761 5917Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029 China
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Impact of small dense low-density lipoprotein cholesterol and triglyceride-rich lipoproteins on plaque rupture with ST-segment elevation myocardial infarction. J Clin Lipidol 2022; 16:725-732. [DOI: 10.1016/j.jacl.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 07/13/2022] [Accepted: 07/24/2022] [Indexed: 11/22/2022]
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Deng F, Li D, Lei L, Yang Q, Li Q, Wang H, Deng J, Zheng Q, Jiang W. Association between apolipoprotein B/A1 ratio and coronary plaque vulnerability in patients with atherosclerotic cardiovascular disease: an intravascular optical coherence tomography study. Cardiovasc Diabetol 2021; 20:188. [PMID: 34526013 PMCID: PMC8442358 DOI: 10.1186/s12933-021-01381-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/07/2021] [Indexed: 01/01/2023] Open
Abstract
Background Apolipoprotein (Apo) A1 and Apo B are strongly associated with the risk of atherosclerotic cardiovascular disease (ASCVD). However, the relationship between the Apo B/A1 ratio and the morphology of coronary vulnerable plaques has not been fully elucidated in patients with ASCVD. Methods A total of 320 patients with ASCVD undergoing percutaneous coronary intervention were enrolled and assigned into acute coronary syndrome (ACS) or chronic coronary syndrome (CCS) group. The morphology of culprit plaque was analyzed by intravascular optical coherence tomography. Association between the Apo B/A1 ratio and coronary vulnerable plaques were evaluated using logistic regression models and receiver operator characteristic (ROC) curve analyses. Results The Apo B/A1 ratio was higher in ACS patients than CCS patients (0.77 ± 0.28 vs. 0.64 ± 0.22, P < 0.001) and it was also higher in patients with plaque rupture, erosion or thrombus than those without culprit plaques. The high Apo B/A1 ratio was associated with high percent of vulnerable plaques compared with low ratio group. The Apo B/A1 ratio was negatively related to fibrous cap thickness in lipid-rich plaque (r = − 0.228, P = 0.043). Univariate and multivariate logistic regression analyses revealed that the Apo B/A1 ratio was an independent factor of plaque rupture, erosion, and thrombus. The area under the ROC curve of the Apo B/A1 ratio for plaque rupture, erosion, and thrombus were 0.632, 0.624, and 0.670 respectively (P < 0.001 for all), which were higher than that of low-density lipoprotein cholesterol. Conclusions The Apo B/A1 ratio is an independent predictor for plaque rupture, erosion, and thrombus in patients with ASCVD. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-021-01381-9.
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Affiliation(s)
- Fuxue Deng
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwulu 157#, Xi'an, 710004, Shaanxi, China
| | - Danni Li
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwulu 157#, Xi'an, 710004, Shaanxi, China
| | - Lei Lei
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwulu 157#, Xi'an, 710004, Shaanxi, China
| | - Qiang Yang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwulu 157#, Xi'an, 710004, Shaanxi, China
| | - Qing Li
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwulu 157#, Xi'an, 710004, Shaanxi, China
| | - Hongtao Wang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwulu 157#, Xi'an, 710004, Shaanxi, China
| | - Jie Deng
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwulu 157#, Xi'an, 710004, Shaanxi, China.
| | - Qiangsun Zheng
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwulu 157#, Xi'an, 710004, Shaanxi, China.
| | - Wei Jiang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwulu 157#, Xi'an, 710004, Shaanxi, China.
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