METHODS: This retrospective cohort study included patients diagnosed with both CAD and psoriasis who underwent coronary angiography at the Fuwai Hospital, Beijing, China, between January 2017 and May 2022. The study endpoint was the occurrence of MACE or end of follow-up time. Multivariate Cox proportional analysis and restricted cubic splines (RCS) were used to determine the association between the TyG index and MACE. Receiver operating characteristic (ROC) curves were used to determine the optimal threshold value of the TyG index for predicting MACE.
RESULTS: This study enrolled 293 patients with both CAD and psoriasis, including 258 (88.1%) males with a mean age of 58.89 ± 9.61 years. Patients were divided into four groups based on the TyG quartiles: Q1 (N = 74), Q2 (N = 73), Q3 (N = 73), and Q4 (N = 73). After adjusting for the potential confounders, the TyG index was independently associated with MACE, both as a continuous variable (HR = 1.53, 95% CI = 1.03-2.28, P = 0.035) and as a categorical variable (Q1: reference; Q2: HR = 1.85, 95% CI = 0.88-3.87, P = 0.105; Q3: HR = 2.39, 95% CI = 1.14-5.00, P = 0.021; Q4: HR = 2.19, 95% CI = 1.001-4.81, P = 0.0497; P for trend = 0.039). RCS analysis showed an linear association between the TyG index and MACE (P-overall = 0.027, P-non-linear = 0.589). ROC curve analysis showed that the TyG index of ≥ 8.73 was the optimal threshold value (area under the ROC curve = 0.60, 95% CI 0.53-0.67). TyG index ≥ 8.73 was significantly associated with MACE (HR = 2.10, 95% CI = 1.32-3.34, P = 0.002). After adjustment for confounders, the TyG index showed independent association with MACE (HR = 2.00, 95% CI = 1.17-3.42, P = 0.011).
CONCLUSIONS: The TyG index showed a positive linear correlation with MACE in patients with both CAD and psoriasis. The TyG index of ≥ 8.73 might be the optimal threshold for predicting MACE.
方法:这项回顾性队列研究包括在阜外医院行冠状动脉造影的同时诊断为CAD和银屑病的患者,北京,中国,2017年1月至2022年5月。研究终点为MACE的发生或随访时间结束。多变量Cox比例分析和限制性三次样条(RCS)用于确定TyG指数与MACE之间的关联。使用受试者工作特征(ROC)曲线来确定用于预测MACE的TyG指数的最佳阈值。
结果:这项研究纳入了293名同时患有CAD和银屑病的患者,其中男性258人(88.1%),平均年龄58.89±9.61岁。根据TyG四分位数将患者分为四组:Q1(N=74),Q2(N=73),Q3(N=73),和Q4(N=73)。在调整了潜在的混杂因素后,TyG指数与MACE独立相关,作为连续变量(HR=1.53,95%CI=1.03-2.28,P=0.035)和分类变量(Q1:参考;Q2:HR=1.85,95%CI=0.88-3.87,P=0.105;Q3:HR=2.39,95%CI=1.14-5.00,P=0.021;Q4:HR=2.19,95%CI=1.001-4.81,P=0.039)RCS分析显示,TyG指数与MACE之间呈线性关系(P总体=0.027,P非线性=0.589)。ROC曲线分析显示,TyG指数≥8.73为最佳阈值(ROC曲线下面积=0.60,95%CI0.53~0.67)。TyG指数≥8.73与MACE显著相关(HR=2.10,95%CI=1.32~3.34,P=0.002)。在对混杂因素进行调整后,TyG指数与MACE独立相关(HR=2.00,95%CI=1.17~3.42,P=0.011)。
结论:在CAD和银屑病患者中,TyG指数与MACE呈正线性相关。TyG指数≥8.73可能是预测MACE的最佳阈值。