PDF(Pubmed)
Abstract：
The triglyceride-glucose (TyG) index and the stress hyperglycaemia ratio (SHR) are both positively associated with cardiovascular (CV) risk in patients with coronary heart disease. However, the prognostic value of these two biomarkers has not been well elucidated in patients with chronic total occlusion (CTO). Therefore, this study aims to evaluate the association of the TyG index and the SHR with long-term prognosis in patients with CTO.
This prospective cohort study consecutively included 2740 angina patients with CTO from January 2017 to December 2018 at Fuwai Hospital. The outcomes are a composite of CV death and target vessel myocardial infarction (TVMI) and major CV cerebrovascular adverse events (MACCEs, including all-cause death, nonfatal MI, ischaemia-driven target vessel revascularization, and stroke). The association between biomarkers and prognosis was analysed by multivariable Cox proportional hazard models, and the predictive value was determined by a receiver-operating characteristic (ROC) curve.
During the follow-up with a median time of 3 years, 179 (6.5%) cases of MACCEs and 47 (1.7%) cases of CV death or TVMI were recorded. Patients with a high TyG index (> 9.10) and a high SHR (> 0.87) showed a significantly increased risk of CV death/TVMI (TyG index: HR 4.23, 95% CI 1.58-11.37; SHR: HR 5.14, 95% CI 1.89-13.98) and MACCEs (TyG index: HR 2.47, 95% CI 1.54-3.97; SHR: HR 2.91, 95% CI 1.84-4.60) compared with those with a low Tyg index and a low SHR (TyG < 8.56, SHR < 0.76). The area under the curve (AUC) values were 0.623 (TyG index) and 0.589 (SHR) for CV death/TVMI and 0.659 (TyG index) and 0.624 (SHR) for MACCEs. Furthermore, patients with both a high TyG index and a high SHR showed the highest risk of clinical outcomes among patients with different levels of these two biomarkers, and the AUC for the TyG-SHR combination was larger than the TyG index alone in predicting MACCE risk.
The study revealed that a high TyG index and a high SHR were significantly correlated with poor prognosis in patients with CTO and suggested that these two biomarkers are reliable in predicting long-term prognosis in CTO patients.
This prospective cohort study consecutively included 2740 angina patients with CTO from January 2017 to December 2018 at Fuwai Hospital. The outcomes are a composite of CV death and target vessel myocardial infarction (TVMI) and major CV cerebrovascular adverse events (MACCEs, including all-cause death, nonfatal MI, ischaemia-driven target vessel revascularization, and stroke). The association between biomarkers and prognosis was analysed by multivariable Cox proportional hazard models, and the predictive value was determined by a receiver-operating characteristic (ROC) curve.
During the follow-up with a median time of 3 years, 179 (6.5%) cases of MACCEs and 47 (1.7%) cases of CV death or TVMI were recorded. Patients with a high TyG index (> 9.10) and a high SHR (> 0.87) showed a significantly increased risk of CV death/TVMI (TyG index: HR 4.23, 95% CI 1.58-11.37; SHR: HR 5.14, 95% CI 1.89-13.98) and MACCEs (TyG index: HR 2.47, 95% CI 1.54-3.97; SHR: HR 2.91, 95% CI 1.84-4.60) compared with those with a low Tyg index and a low SHR (TyG < 8.56, SHR < 0.76). The area under the curve (AUC) values were 0.623 (TyG index) and 0.589 (SHR) for CV death/TVMI and 0.659 (TyG index) and 0.624 (SHR) for MACCEs. Furthermore, patients with both a high TyG index and a high SHR showed the highest risk of clinical outcomes among patients with different levels of these two biomarkers, and the AUC for the TyG-SHR combination was larger than the TyG index alone in predicting MACCE risk.
The study revealed that a high TyG index and a high SHR were significantly correlated with poor prognosis in patients with CTO and suggested that these two biomarkers are reliable in predicting long-term prognosis in CTO patients.
摘要：
背景：冠心病患者的甘油三酯-葡萄糖（TyG）指数和应激性高血糖率（SHR）均与心血管（CV）风险呈正相关。然而,这两种生物标志物在慢性完全闭塞(CTO)患者中的预后价值尚未得到很好的阐明.因此,本研究旨在评估TyG指数和SHR与CTO患者长期预后的关系.
方法：这项前瞻性队列研究连续纳入2017年1月至2018年12月在阜外医院接受CTO治疗的2740例心绞痛患者。结果是心血管死亡和靶血管心肌梗死(TVMI)和主要心血管脑血管不良事件(MACCEs,包括全因死亡,非致死性MI,缺血驱动的靶血管血运重建，和中风）。通过多变量Cox比例风险模型分析生物标志物与预后之间的关系，预测值由受试者工作特征(ROC)曲线确定。
结果：在中位时间为3年的随访期间，记录了179例（6.5％）MACCE和47例（1.7％）CV死亡或TVMI。具有高TyG指数（>9.10）和高SHR（>0.87）的患者显示出CV死亡/TVMI（TyG指数：HR4.23，95％CI1.58-11.37；SHR：HR5.14，95％CI1.89-13.98）和MACCE（TyG指数：HR2.47，95％CI1.54-3.97；SHR：0.91，95％结论：研究显示，高TyG指数和高SHR与CTO患者的不良预后显著相关，提示这两种生物标志物在预测CTO患者的长期预后方面是可靠的。
方法：这项前瞻性队列研究连续纳入2017年1月至2018年12月在阜外医院接受CTO治疗的2740例心绞痛患者。结果是心血管死亡和靶血管心肌梗死(TVMI)和主要心血管脑血管不良事件(MACCEs,包括全因死亡,非致死性MI,缺血驱动的靶血管血运重建，和中风）。通过多变量Cox比例风险模型分析生物标志物与预后之间的关系，预测值由受试者工作特征(ROC)曲线确定。
结果：在中位时间为3年的随访期间，记录了179例（6.5％）MACCE和47例（1.7％）CV死亡或TVMI。具有高TyG指数（>9.10）和高SHR（>0.87）的患者显示出CV死亡/TVMI（TyG指数：HR4.23，95％CI1.58-11.37；SHR：HR5.14，95％CI1.89-13.98）和MACCE（TyG指数：HR2.47，95％CI1.54-3.97；SHR：0.91，95％
