Association between insulin resistance indices and outcomes in patients with heart failure with preserved ejection fraction
Authors' conclusion
All four IR indices are independently associated with MACE in patients with HFpEF. Notably, these IR indices significantly enhance the predictive accuracy of the MAGGIC score, a widely used risk assessment tool in HFpEF. Among these indices, the TyG index demonstrated the highest discriminatory and reclassification abilities, providing the greatest incremental value in predicting MACE and exhibiting significant superiority compared to the other indices. These findings highlight the importance of assessing IR indices, particularly the TyG index, in the risk assessment and management strategies for HFpEF patients. However, it should be noted that our findings need to be validated in diverse populations to ensure their applicability and generalizability.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF) recruited January 2012–December 2023; mean age 70.59 ± 10.6 years, 5045 (58.04%) male
- Participants
- 8,693 patients
- Exposure
- Higher vs lower insulin resistance indices
- Outcome
- MACE: all-cause mortality and rehospitalization for HF
Main finding
As reported in the abstract
- Higher degree of the four insulin resistance (IR) indexes associated with higher risk of major adverse cardiovascular event (MACE) (Kaplan-Meier)
- all log-rank P < 0.05
Observational data: associations, not effects.
Further findings
Incremental prognostic value of triglyceride-glucose (TyG) index added to MAGGIC score
- AUC of MAGGIC score from 0.601 to 0.666 with TyG index
- TyG index had superior discrimination and reclassification vs other IR indicators
TyG-BMI and MACE
- U-shaped correlation: both elevated and lower TyG-BMI associated with increased risk
Original publication
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