Author:
Zhang Wen,Liu Lu,Yin Guoqing,Mohammed Abdul-Quddus,Xiang Lanqing,Lv Xian,Shi Tingting,Galip Jassur,Wang Chunyue,Mohammed Ayman A.,Mareai Redhwan M.,Yu Fei,Abdu Fuad A.,Che Wenliang
Abstract
Abstract
Background
Ischemia and no obstructive coronary artery disease (INOCA) is increasingly recognized and associated with poor outcomes. The triglyceride-glucose (TyG) index is a reliable alternative measure of insulin resistance significantly linked to cardiovascular disease and adverse prognosis. We investigated the association between the TyG index and myocardial ischemia and the prognosis in INOCA patients.
Methods
INOCA patients who underwent both coronary angiography and myocardial perfusion imaging (MPI) were included consecutively. All participants were divided into three groups according to TyG tertiles (T1, T2, and T3). Abnormal MPI for myocardial ischemia in individual coronary territories was defined as summed stress score (SSS) ≥ 4 and summed difference score (SDS) ≥ 2. SSS refers to the sum of all defects in the stress images, and SDS is the difference of the sum of all defects between the rest images and stress images. All patients were followed up for major adverse cardiac events (MACE).
Results
Among 332 INOCA patients, 113 (34.0%) had abnormal MPI. Patients with higher TyG index had a higher rate of abnormal MPI (25.5% vs. 32.4% vs. 44.1%; p = 0.012). Multivariate logistic analysis showed that a high TyG index was significantly correlated with abnormal MPI in INOCA patients (OR, 1.901; 95% CI, 1.045–3.458; P = 0.035). During the median 35 months of follow-up, 83 (25%) MACE were recorded, and a higher incidence of MACE was observed in the T3 group (T3 vs. T2 vs. T1: 36.9% vs. 21.6% vs. 16.4%, respectively; p = 0.001). In multivariate Cox regression analysis, the T3 group was significantly associated with the risk of MACE compared to the T1 group (HR, 2.338; 95% CI 1.253–4.364, P = 0.008).
Conclusion
This study indicates for the first time that the TyG index is significantly associated with myocardial ischemia and poor prognosis among INOCA patients.
Funder
Chinese National Natural Science Foundation
Shanghai Natural Science Foundation of China
Foundation of Shanghai Municipal Health Commission
Tibet Natural Science Foundation of China
Foundation of Chongming
Clinical Research Plan of Shanghai Tenth People’s Hospital
Clinical Research Plan of SHDC
Foundation of the Science and Technology Commission of Shanghai Municipality
Publisher
Springer Science and Business Media LLC
Cited by
2 articles.
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