Lipids & metabolic liver disease
Prognostic effect of the triglyceride glucose (TyG) index on patients with severe aortic stenosis following transcatheter aortic valve replacement: a retrospective cohort study
Authors' conclusion
In patients with severe AS receiving TAVR, there was a positive linear relationship between TyG index and poor prognosis, with 8.4 as the optimal bivariate cutoff value. Our findings suggest TyG index holds potential value for risk stratification and guiding therapeutic decisions in patients after TAVR.
Study context
- Population
- Patients with severe aortic stenosis (AS) who underwent transcatheter aortic valve replacement (TAVR) at West China Hospital of Sichuan University, April 2014–August 2023
- Participants
- 1,569 patients
- Exposure
- Per-unit increase in TyG index
- Outcome
- All-cause mortality, cardiovascular mortality and MACE
- Follow-up
- Median 1.09 years
Methodological detailssingle-centre, consecutive enrolment
- Single-centre
- Consecutive enrolment
Main finding
As reported in the abstract
All-cause mortality, cardiovascular mortality and MACE per unit increase of TyG index
- Patients with all-cause death
- 146
- Patients with cardiovascular death
- 70
- Patients with MACE
- 196
- All-cause mortality per unit TyG increase, aHR
- 5.41 (4.01-7.32) (95% CI)
- Cardiovascular mortality per unit TyG increase, aHR
- 4.85 (3.16-7.43) (95% CI)
- MACE per unit TyG increase, aHR
- 4.47 (3.42-5.85) (95% CI)
Observational data: associations, not effects.
Further findings
Shape of association (RCS)
- Optimal binary cutoff of TyG index
- 8.40
- Linear association between TyG index and endpoints (all P for non-linearity > 0.05)
Incremental prognostic value of adding TyG index to basic risk model
- All-cause mortality integrated discrimination improvement (IDI)
- 0.11, P < 0.001
- All-cause mortality net reclassification improvement (NRI)
- 0.32, P < 0.001
- Cardiovascular mortality IDI
- 0.043, P < 0.001
- Cardiovascular mortality NRI
- 0.37, P < 0.001
- MACE IDI
- 0.092, P < 0.001
- MACE NRI
- 0.32, P < 0.001
- Time-dependent Harrell's C-index increased for all endpoints
Original publication
Prognostic effect of the TyG index on patients with severe aortic stenosis following transcatheter aortic valve replacement: a retrospective cohort study. Cardiovasc Diabetol. Published 24 August 2024. doi:10.
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