Improving cardiovascular risk stratification through the derivation and validation of an elevated triglyceride‐glucose index
Authors' conclusion
TyG is associated with increased prevalence and progression of subclinical and clinically overt ASCVD. In individuals assessed for primary prevention a TyG≥8.46 may serve as a risk enhancer.
Study context
- Population
- General population cohort (ATTICA); primary prevention validation cohort; patients from atherosclerotic cardiovascular disease (ASCVD) risk registry (Athens Cardiometabolic Cohort)derivation cohort
- Participants
- 1,677 participants
- Exposure
- Elevated triglyceride-glucose (TyG) index vs lower TyG index
- Outcome
- Composite of:
- Cardiovascular mortality
- MI
- Coronary revascularization
- Stroke
Methodological detailsderivation and external validation, consecutively recruited registry, Validation cohort n = 1237; registry n = 1170, TyG = ln[fasting TG (mg/dL) × fasting glucose (mg/dL)/2]
- Derivation and external validation
- Consecutively recruited registry
- Validation cohort n = 1237; registry n = 1170
- TyG = ln[fasting TG (mg/dL) × fasting glucose (mg/dL)/2]
Main finding
As reported in the abstract
TyG index independently associated with increased CVD events, HR
1.33
p = 0.020
Optimal prognostic TyG cut-off
8.46
Net reclassification index (NRI) over SCORE2, derivation and validation cohorts
0.668 and 0.469
p < 0.05 for all
Delta Harrell's C index over SCORE2, derivation and validation cohorts
0.054 and 0.044
p < 0.05 for all
Observational data: associations, not effects.
Further findings
More diseased vascular beds with elevated TyG (Athens Cardiometabolic Cohort)
- OR
- 2.00, 95% CI 1.24-3.24
Progression of subclinical carotid atherosclerosis with elevated TyG · follow-up
- OR
- 2.99, 95% CI 1.10-8.17
Established ASCVD with elevated TyG
- Elevated TyG associated with established ASCVD
- P < 0.05
Original publication
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