Association between the insulin resistance and all-cause mortality in patients with moderate and severe aortic stenosis: a retrospective cohort study
-
Published:2023-09-02
Issue:1
Volume:22
Page:
-
ISSN:1475-2840
-
Container-title:Cardiovascular Diabetology
-
language:en
-
Short-container-title:Cardiovasc Diabetol
Author:
Huang Rihua,Xu Xinghao,Xu Chaoguang,Zhang Shaozhao,Xiong Zhenyu,Liu Menghui,Huang Yiquan,Wen Han,Guo Yue,Liao Xinxue,Zhuang Xiaodong
Abstract
Abstract
Background
The triglyceride-glucose (TyG) index is a reliable surrogate marker of insulin resistance (IR). However, whether the TyG index has prognostic value in patients with moderate to severe aortic stenosis (AS) remains unclear.
Methods
This study enrolled 317 patients with moderate to severe AS at the First Affiliated Hospital of Sun Yat-Sen University. The patients were grouped according to the cut-off value of the TyG index. Cox regression with Firth’s penalized maximum likelihood method and restricted cubic splines regression were conducted to assess the association between the TyG index and all-cause mortality. The added value of the TyG index included in the traditional risk factors model for outcome prediction was also analyzed.
Results
Among 317 patients (mean age 67.70 years, 62.8% male), there was 84 all-cause mortality during a median 38.07 months follow-up. After fully adjusting for confounders, a per-unit increase in the TyG index was associated with a 62% higher all-cause mortality risk (HR 1.622, 95% CI 1.086–2.416, p = 0.018). The restricted cubic splines regression model revealed a linear association between the TyG index and the risk of all-cause mortality (p for nonlinearity = 0.632). The addition of the TyG index in the basic risk model has an incremental effect on the prediction of mortality [C-statistic change from 0.755 to 0.768; continuous net reclassification improvement (95% CI): 0.299 (0.051–0.546), p = 0.017; integrated discrimination improvement: 0.017 (0.001–0.033), p = 0.044].
Conclusions
Higher IR assessed by the TyG index was associated with a higher risk of all-cause mortality in patients with moderate and severe AS.
Funder
Guangdong Basic and Applied Basic Research Foundation the China Postdoctoral Science special Foundation funded project the National Natural Science Foundation of China Basic and Applied Basic Research Foundation of Guangdong Province
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine,Endocrinology, Diabetes and Metabolism
Reference37 articles.
1. Goody PR, Hosen MR, Christmann D, Niepmann ST, Zietzer A, Adam M, Bonner F, Zimmer S, Nickenig G, Jansen F. Aortic valve stenosis: from Basic Mechanisms to Novel therapeutic targets. Arterioscler Thromb Vasc Biol. 2020;40(4):885–900. 2. Coffey S, Roberts-Thomson R, Brown A, Carapetis J, Chen M, Enriquez-Sarano M, Zuhlke L, Prendergast BD. Global epidemiology of valvular heart disease. Nat Rev Cardiol. 2021;18(12):853–64. 3. Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J, Capodanno D, Conradi L, De Bonis M, De Paulis R, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J. 2022;43(7):561–632. 4. Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP 3rd, Gentile F, Jneid H, Krieger EV, Mack M, McLeod C, et al. 2020 ACC/AHA Guideline for the management of patients with Valvular Heart Disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021;143(5):e72–e227. 5. Laakso M, Kuusisto J. Insulin resistance and hyperglycaemia in cardiovascular disease development. Nat Rev Endocrinol. 2014;10(5):293–302.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|