Predictive Effect of Triglyceride‑Glucose Index on Clinical Events In Patients With Type 2 Diabetes Mellitus and Acute Myocardial Infarction: Results From an Observational Cohort Study In China

Background: Triglyceride glucose (TyG) index is considered a reliable alternative marker of insulin resistance and an independent predictor of cardiovascular outcomes. However, the prognostic value of TyG index in patients with type 2 diabetes mellitus (T 2 DM) and acute myocardial infarction (AMI) remains unclear. Methods: : A total of 1932 consecutive patients with T 2 DM and AMI were enrolled in this study. Patients were divided into tertiles according to their TyG index levels. The incidences of major adverse cardiac and cerebral events (MACCEs), including all-cause death, non-fatal MI, non-fatal stroke, cardiac rehospitalization and revascularization, were recorded. The TyG index was calculated as the ln [fasting triglycerides (mg/dL) ×fasting plasma glucose (mg/dL)/2]. Results: : Kaplan-Meier curves showed that the incidences of cardiac rehospitalization ( p =0.001), revascularization ( p <0.001) and composite MACCEs ( p =0.027) increased with TyG index tertiles. Multivariable Cox regression models revealed that the TyG index was positively associated with all-cause death, cardiovascular death, cardiac rehospitalization, revascularization and composite MACCEs. The addition of TyG index to a baseline risk model had an incremental effect on the predictive value for composite MACCEs [AUC: 0.663 vs. 0.708, p <0.001]. Conclusions: : The TyG index was significantly associated with MACCEs, suggesting that the TyG index may be a valid marker for risk stratification and prognosis in patients with T 2 DM and AMI. Trial registration: retrospectively registered