Association of prediabetes and insulin resistance on prognosis of patients with moderate-to-severe coronary artery calcification: a prospective cohort study
Main finding · MACEResult — go to the resultAdjusted hazard ratio 1.79 95% CI 1.07–2.99Authors' conclusion
This study highlights the prognostic value of WHO/IEC-defined prediabetes and the TyG index in identifying high-risk individuals among patients with MSCAC. Integrating these measures into clinical risk assessment may enhance prognostic accuracy and inform more targeted prevention strategies.
Study context
- Population
- Patients with angiography-detected moderate-to-severe coronary artery calcification (MSCAC)
- Participants
- 4,195 patients
- Exposure
- Prediabetes vs normoglycaemia; Triglyceride-glucose (TyG) index tertiles
- Outcome
- MACE: cardiovascular death, nonfatal MI and stroke
- Follow-up
- Median 3.1 years
Methodological detailsconsecutive enrolment
- Consecutive enrolment
Main finding
MACE
Adjusted hazard ratio
1.79
95% CI 1.07–2.99
WHO/IEC prediabetesvs Normoglycemia
aHR 1.79 (95% CI 1.07–2.99)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| MACE by TyG index tertileHighest TyG tertilevs Lowest TyG tertile | 2.25 (1.30–3.90) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
- Major adverse cardiovascular events (MACE) by TyG index tertile — Positive linear association between TyG index and MACE risk
- P for nonlinearity > 0.05
Prediabetes prevalence
- American Diabetes Association (ADA)-defined prediabetes
- 36.6%
- World Health Organization (WHO)/International Expert Committee (IEC)-defined prediabetes
- 17.9%
MACE by WHO/IEC prediabetes and TyG index combined
- Prediabetes and high TyG index, aHR
- 2.43 (95% CI 1.12-5.32)
- Prediabetes and low TyG index, aHR
- 1.60 (95% CI 0.90-2.85)
Risk prediction
- Adding both WHO/IEC glycaemic status and TyG index to the baseline model improved C-statistic, continuous NRI and IDI vs either alone
- Consistent in subgroup and sensitivity analyses
Original publication
Association of prediabetes and insulin resistance on prognosis of patients with moderate-to-severe coronary artery calcification: a prospective cohort study. Cardiovasc Diabetol. Published 2 July 2025. doi:10.
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