Trigliserit-glikoz indeksi ST-segment yükselmeli miyokard enfarktüslü hastalarda rezidüel SYNTAX skoru ile ilişkilidir
Year 2023,
Volume: 48 Issue: 1, 92 - 100, 31.03.2023
Yalçın Avcı
,
Ali Rıza Demir
,
Arda Güler
,
Tugba Aktemur
,
Serkan Kahraman
,
Begüm Uygur
,
Gökhan Demirci
,
Enes Arslan
,
Ahmet Emir Ulutaş
,
Mehmet Erturk
Abstract
Amaç: Trigliserit-glukoz indeksi (TyG) insülin direncini yansıtan önemli bir parametredir ve son yıllarda kullanımı artmıştır. Kardiyovasküler hastalıklarla ilişkisi daha önceki çalışmalarda gösterilmiştir. Amacımız, primer perkütan koroner girişim uygulanan ST segment yükselmeli miyokard enfarktüsü (STEMI) hastalarında rezidüel SYNTAX skorunun (rSS) TyG indeksi ile ilişkisini araştırmaktır.
Gereç ve Yöntem: Çalışmaya primer perkütan koroner girişim uygulanan toplam 663 STEMI hastası dahil edildi. Hastalar, TyG indeks düzeyine göre yüksek ve düşük olmak üzere iki gruba ayrıldı. TyG indeksi için cut-off değeri ROC analizi ile 9,61 olarak belirlendi. Başlangıç klinik ve demografik değişkenlerin yanı sıra koroner arter hastalığı şiddeti her iki grup için de hesaplandı.
Bulgular: Yüksek TyG indeksi grubunda 281 hasta ve düşük TyG indeksi grubunda 386 hasta değerlendirildi. 8'in üzerindeki rSS, yüksek olarak kabul edildi. Artmış TyG indeksi grubunda yüksek rSS olan hastaların oranı diğer gruba göre anlamlı derecede yüksek bulundu [114 (40.6) vs. 54 (14.0]. Ek olarak, lojistik regresyon analizinde daha yüksek TyG indeksi, daha yüksek rSS’nin bağımsız öngörücüsü olarak belirlenir.
Sonuç: Yüksek TyG indeksi, rSS ile güçlü bir ilişkiye sahiptir ve daha yüksek TyG indeksi, STEMI hastalarında artan rSS'nin bağımsız bir öngördürücüsüdür.
References
- Lee JH, Park HS, Chae SC, Cho Y, Yang DH, Jeong MH et al. Predictors of six-month major adverse cardiac events in 30-day survivors after acute myocardial infarction (from the Korea Acute Myocardial Infarction Registry). Am J Cardiol. 2009;104:182-9.
- Toma M, Buller CE, Westerhout CM, Fu Y, O’Neill WW, Holmes DR et al. Non-culprit coronary artery percutaneous coronary intervention during acute ST-segment elevation myocardial infarction: insights from the APEX-AMI trial. Eur Heart J. 2010;31:1701-7.
- Généreux P, Palmerini T, Caixeta A, Rosner G, Green P, Dressler O et al. Quantification and impact of untreated coronary artery disease after percutaneous coronary intervention: the residual SYNTAX (Synergy Between PCI with Taxus and Cardiac Surgery) score. J Am Coll Cardiol. 2012;59:2165-74.
- Patel TP, Rawal K, Bagchi AK, Akolkar G, Bernardes N, Dias D da S et al. Insulin resistance: an additional risk factor in the pathogenesis of cardiovascular disease in type 2 diabetes. Heart Fail Rev. 2016;21:11-23.
- Leon BM, Maddox TM. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes. 2015;6:1246-58.
- Ormazabal V, Nair S, Elfeky O, Aguayo C, Salomon C, Zuñiga FA. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol. 2018;17:122.
- Petersen MC, Shulman GI. Mechanisms of insulin action and insulin resistance. Physiol Rev. 2018;98:2133-223.
- Tam CS, Xie W, Johnson WD, Cefalu WT, Redman LM, Ravussin E. Defining insulin resistance from hyperinsulinemic-euglycemic clamps. Diabetes Care. 2012;35:1605-10.
- Sánchez-García A, Rodríguez-Gutiérrez R, Mancillas-Adame L, González-Nava V, Díaz González-Colmenero A, Solis RC et al. Diagnostic accuracy of the triglyceride and glucose index for insulin resistance: A systematic review. Int J Endocrinol. 2020;2020:e4678526.
- Liu X cong, He G dong, Lo K, Huang Y qing, Feng Y qing. The triglyceride-glucose index, an insulin resistance marker, was non-linear associated with all-cause and cardiovascular mortality in the general population. Front Cardiovasc Med 2021;7.
- Si Y, Fan W, Han C, Liu J, Sun L. Atherogenic index of plasma, triglyceride-glucose index and monocyte-to-lymphocyte ratio for predicting subclinical coronary artery disease. Am J Med Sci. 2021;362:285-90.
- Jin JL, Cao YX, Wu LG, You XD, Guo YL, Wu NQ et al. Triglyceride glucose index for predicting cardiovascular outcomes in patients with coronary artery disease. J Thorac Dis. Nov 2018;10:6137-46.
- Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA et al. Fourth universal definition of myocardial infarction (2018). J Am Coll Cardiol. 2018;72:2231-64.
- Navarro-González D, Sánchez-Íñigo L, Pastrana-Delgado J, Fernández-Montero A, Martinez JA. Triglyceride–glucose index (TyG index) in comparison with fasting plasma glucose improved diabetes prediction in patients with normal fasting glucose: The Vascular-Metabolic CUN cohort. Prev Med. 01 May 2016;86:99-105.
- Farooq V, Brugaletta S, Serruys PW. The SYNTAX score and SYNTAX-based clinical risk scores. Semin Thorac Cardiovasc Surg. 2011;23:99-105.
- Selvi NMK, Nandhini S, Sakthivadivel V, Lokesh S, Srinivasan AR, Sumathi S. Association of triglyceride-glucose index (TyG index) with HbA1c and insulin resistance in type 2 diabetes mellitus. Maedica. 2021;16:375-81.
- Zhao S, Yu S, Chi C, Fan X, Tang J, Ji H et al. Association between macro- and microvascular damage and the triglyceride glucose index in community-dwelling elderly individuals: the Northern Shanghai Study. Cardiovasc Diabetol. 2019;18:95.
- Pan Y, Zhong S, Zhou K, Tian Z, Chen F, Liu Z et al. Association between diabetes complications and the triglyceride-glucose index in hospitalized patients with type 2 diabetes. J Diabetes Res. 2021;2021:8757996.
- Okamura T, Hashimoto Y, Hamaguchi M, Obora A, Kojima T, Fukui M. Triglyceride–glucose index is a predictor of incident chronic kidney disease: a population-based longitudinal study. Clin Exp Nephrol. 2019;23:948-55.
- Srinivasan S, Singh P, Kulothungan V, Sharma T, Raman R. Relationship between triglyceride glucose index, retinopathy and nephropathy in type 2 diabetes. Endocrinol Diabetes Metab. 2021;4:e00151.
- Puymirat E, Simon T, Cayla G, Cottin Y, Elbaz M, Coste P et al. Acute myocardial infarction: changes in patient characteristics, management, and 6-month outcomes over a period of 20 years in the FAST-MI program (French registry of acute ST-elevation or non-ST-elevation myocardial infarction) 1995 to 2015. Circulation. 2017;136:1908-19.
- Kahraman S, Agus HZ, Avci Y, Serbest NG, Guner A, Erturk M. The neutrophil to lymphocyte ratio (NLR) is associated with residual syntax score in patients with ST-segment elevation myocardial infarction. Angiology. 2021;72:166-73.
- Li JJ, Zhu CG, Yu B, Liu YX, Yu MY. The role of inflammation in coronary artery calcification. 2018;392:894-6. 25. Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC), European Association for the Study of Diabetes (EASD)Ageing Res Rev. 2007;6:263-70.
- Mahabadi AA, Rassaf T. Imaging of coronary inflammation for cardiovascular risk prediction. The Lancet. 2018;392:894-6.
- Rydén L, Grant PJ, Anker SD, Berne C, Cosentino F, Danchin N et al. ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD - summary. Diab Vasc Dis Res. 2014 May;11:133-73.
- Mao Q, Zhou D, Li Y, Wang Y, Xu SC, Zhao XH. The triglyceride-glucose index predicts coronary artery disease severity and cardiovascular outcomes in patients with non-ST-segment elevation acute coronary syndrome. Dis Markers. 2019;2019:6891537.
- Luo E, Wang D, Yan G, Qiao Y, Liu B, Hou J et al. High triglyceride–glucose index is associated with poor prognosis in patients with acute ST-elevation myocardial infarction after percutaneous coronary intervention. Cardiovasc Diabetol. 2019;18:150.
- Roberts WC, Shirani J. Comparison of cardiac findings at necropsy in octogenarians, nonagenarians, and centenarians. Am J Cardiol. 1998;82:627-31.
- Kannel WB. Coronary heart disease risk factors in the elderly. Am J Geriatr Cardiol. 2002;11:101-7.
- Morici N, Alicandro G, Ferri LA, Piatti L, Grosseto D, Sganzerla P et al. Residual SYNTAX score and one-year outcome in elderly patients with acute coronary syndrome. CJC Open. 2020;2:236-43.
Triglyceride-glucose index is associated with residual SYNTAX score in patients with ST-segment elevation myocardial infarction
Year 2023,
Volume: 48 Issue: 1, 92 - 100, 31.03.2023
Yalçın Avcı
,
Ali Rıza Demir
,
Arda Güler
,
Tugba Aktemur
,
Serkan Kahraman
,
Begüm Uygur
,
Gökhan Demirci
,
Enes Arslan
,
Ahmet Emir Ulutaş
,
Mehmet Erturk
Abstract
Purpose: The triglyceride-glucose index (TyG) is an important parameter that reflects insulin resistance and its use has increased recently. Its relationship with cardiovascular diseases has been shown in previous studies. Our aim was to investigate the association of residual SYNTAX score (rSS) with TyG index in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention.
Materials and Methods: A total of 663 STEMI patients who underwent primary percutaneous coronary intervention were included in the study. The patients were divided into 2 groups according to the TyG index level as high and low. The cut-off value for the TyG index was determined as 9.61 by ROC analysis. Coronary artery disease severity was calculated for both groups besides baseline clinical and demographic variables.
Results: A total of 281 patients were evaluated in the high TyG index group and 386 patients in the low TyG index group. A rSS above 8 was considered high. The proportion of patients with high rSS in the increased TyG index group was found to be significantly higher than in the other group [114 (40.6) vs. 54 (14.0)]. In addition, higher TyG index is determined to be the independent predictor of higher rSS in logistic regression analysis.
Conclusion: High TyG index had a strong association with rSS and higher TyG index was an independent predictor of increased rSS in patients with STEMI
References
- Lee JH, Park HS, Chae SC, Cho Y, Yang DH, Jeong MH et al. Predictors of six-month major adverse cardiac events in 30-day survivors after acute myocardial infarction (from the Korea Acute Myocardial Infarction Registry). Am J Cardiol. 2009;104:182-9.
- Toma M, Buller CE, Westerhout CM, Fu Y, O’Neill WW, Holmes DR et al. Non-culprit coronary artery percutaneous coronary intervention during acute ST-segment elevation myocardial infarction: insights from the APEX-AMI trial. Eur Heart J. 2010;31:1701-7.
- Généreux P, Palmerini T, Caixeta A, Rosner G, Green P, Dressler O et al. Quantification and impact of untreated coronary artery disease after percutaneous coronary intervention: the residual SYNTAX (Synergy Between PCI with Taxus and Cardiac Surgery) score. J Am Coll Cardiol. 2012;59:2165-74.
- Patel TP, Rawal K, Bagchi AK, Akolkar G, Bernardes N, Dias D da S et al. Insulin resistance: an additional risk factor in the pathogenesis of cardiovascular disease in type 2 diabetes. Heart Fail Rev. 2016;21:11-23.
- Leon BM, Maddox TM. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes. 2015;6:1246-58.
- Ormazabal V, Nair S, Elfeky O, Aguayo C, Salomon C, Zuñiga FA. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol. 2018;17:122.
- Petersen MC, Shulman GI. Mechanisms of insulin action and insulin resistance. Physiol Rev. 2018;98:2133-223.
- Tam CS, Xie W, Johnson WD, Cefalu WT, Redman LM, Ravussin E. Defining insulin resistance from hyperinsulinemic-euglycemic clamps. Diabetes Care. 2012;35:1605-10.
- Sánchez-García A, Rodríguez-Gutiérrez R, Mancillas-Adame L, González-Nava V, Díaz González-Colmenero A, Solis RC et al. Diagnostic accuracy of the triglyceride and glucose index for insulin resistance: A systematic review. Int J Endocrinol. 2020;2020:e4678526.
- Liu X cong, He G dong, Lo K, Huang Y qing, Feng Y qing. The triglyceride-glucose index, an insulin resistance marker, was non-linear associated with all-cause and cardiovascular mortality in the general population. Front Cardiovasc Med 2021;7.
- Si Y, Fan W, Han C, Liu J, Sun L. Atherogenic index of plasma, triglyceride-glucose index and monocyte-to-lymphocyte ratio for predicting subclinical coronary artery disease. Am J Med Sci. 2021;362:285-90.
- Jin JL, Cao YX, Wu LG, You XD, Guo YL, Wu NQ et al. Triglyceride glucose index for predicting cardiovascular outcomes in patients with coronary artery disease. J Thorac Dis. Nov 2018;10:6137-46.
- Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA et al. Fourth universal definition of myocardial infarction (2018). J Am Coll Cardiol. 2018;72:2231-64.
- Navarro-González D, Sánchez-Íñigo L, Pastrana-Delgado J, Fernández-Montero A, Martinez JA. Triglyceride–glucose index (TyG index) in comparison with fasting plasma glucose improved diabetes prediction in patients with normal fasting glucose: The Vascular-Metabolic CUN cohort. Prev Med. 01 May 2016;86:99-105.
- Farooq V, Brugaletta S, Serruys PW. The SYNTAX score and SYNTAX-based clinical risk scores. Semin Thorac Cardiovasc Surg. 2011;23:99-105.
- Selvi NMK, Nandhini S, Sakthivadivel V, Lokesh S, Srinivasan AR, Sumathi S. Association of triglyceride-glucose index (TyG index) with HbA1c and insulin resistance in type 2 diabetes mellitus. Maedica. 2021;16:375-81.
- Zhao S, Yu S, Chi C, Fan X, Tang J, Ji H et al. Association between macro- and microvascular damage and the triglyceride glucose index in community-dwelling elderly individuals: the Northern Shanghai Study. Cardiovasc Diabetol. 2019;18:95.
- Pan Y, Zhong S, Zhou K, Tian Z, Chen F, Liu Z et al. Association between diabetes complications and the triglyceride-glucose index in hospitalized patients with type 2 diabetes. J Diabetes Res. 2021;2021:8757996.
- Okamura T, Hashimoto Y, Hamaguchi M, Obora A, Kojima T, Fukui M. Triglyceride–glucose index is a predictor of incident chronic kidney disease: a population-based longitudinal study. Clin Exp Nephrol. 2019;23:948-55.
- Srinivasan S, Singh P, Kulothungan V, Sharma T, Raman R. Relationship between triglyceride glucose index, retinopathy and nephropathy in type 2 diabetes. Endocrinol Diabetes Metab. 2021;4:e00151.
- Puymirat E, Simon T, Cayla G, Cottin Y, Elbaz M, Coste P et al. Acute myocardial infarction: changes in patient characteristics, management, and 6-month outcomes over a period of 20 years in the FAST-MI program (French registry of acute ST-elevation or non-ST-elevation myocardial infarction) 1995 to 2015. Circulation. 2017;136:1908-19.
- Kahraman S, Agus HZ, Avci Y, Serbest NG, Guner A, Erturk M. The neutrophil to lymphocyte ratio (NLR) is associated with residual syntax score in patients with ST-segment elevation myocardial infarction. Angiology. 2021;72:166-73.
- Li JJ, Zhu CG, Yu B, Liu YX, Yu MY. The role of inflammation in coronary artery calcification. 2018;392:894-6. 25. Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC), European Association for the Study of Diabetes (EASD)Ageing Res Rev. 2007;6:263-70.
- Mahabadi AA, Rassaf T. Imaging of coronary inflammation for cardiovascular risk prediction. The Lancet. 2018;392:894-6.
- Rydén L, Grant PJ, Anker SD, Berne C, Cosentino F, Danchin N et al. ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD - summary. Diab Vasc Dis Res. 2014 May;11:133-73.
- Mao Q, Zhou D, Li Y, Wang Y, Xu SC, Zhao XH. The triglyceride-glucose index predicts coronary artery disease severity and cardiovascular outcomes in patients with non-ST-segment elevation acute coronary syndrome. Dis Markers. 2019;2019:6891537.
- Luo E, Wang D, Yan G, Qiao Y, Liu B, Hou J et al. High triglyceride–glucose index is associated with poor prognosis in patients with acute ST-elevation myocardial infarction after percutaneous coronary intervention. Cardiovasc Diabetol. 2019;18:150.
- Roberts WC, Shirani J. Comparison of cardiac findings at necropsy in octogenarians, nonagenarians, and centenarians. Am J Cardiol. 1998;82:627-31.
- Kannel WB. Coronary heart disease risk factors in the elderly. Am J Geriatr Cardiol. 2002;11:101-7.
- Morici N, Alicandro G, Ferri LA, Piatti L, Grosseto D, Sganzerla P et al. Residual SYNTAX score and one-year outcome in elderly patients with acute coronary syndrome. CJC Open. 2020;2:236-43.