Synergistic effects of insulin resistance and revascularization completeness on prognosis in patients with coronary artery calcification
Main finding · CV death/TVMIResult — go to the resultAdjusted hazard ratio 0.53 95% CI 0.32–0.87Authors' conclusion
Our findings suggest that optimal revascularization during PCI is associated with improved long-term clinical outcomes in patients with MSCAC, particularly in those with a high level of insulin resistance.
Study context
- Population
- Patients who received percutaneous coronary intervention (PCI) for moderate-to-severe coronary artery calcification (MSCAC) at Fuwai Hospital, January 2017 to December 2018; insulin resistance by triglyceride-glucose (TyG) index tertiles (T1: <8.66; T2: 8.66–9.14; T3: ≥9.14)
- Participants
- 4,087 patients
- Exposure
- Optimal or suboptimal revascularization vs MSCAC-PCI failure, by TyG index tertile
- Optimal revascularizationn = 3,546
- Suboptimal revascularizationn = 274
- Failuren = 267reference
- Outcome
- Composite of:
- CV death
- Target-vessel MI (target-vessel myocardial infarction (TVMI))
- Follow-up
- Median 3 years
Methodological detailssingle-centre
- Single-centre
Main finding
CV death/TVMI
Adjusted hazard ratio
0.53
95% CI 0.32–0.87
Optimal revascularizationvs Failure
aHR 0.53 (95% CI 0.32–0.87)
As reported in the abstract
- Patients with primary outcome (overall)
- 154 (3.77%)
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| CV death/TVMI, TyG T3 subgroupOptimal revascularizationvs Failure | 0.45 (0.21–0.97) | |
| CV death, TyG T3 subgroupOptimal revascularizationvs Failure | 0.29 (0.10–0.78) | |
| 0.10.31310Adjusted hazard ratio (log scale) |
PCI outcomes, TyG T1 and T2 subgroups
- No substantial variations in PCI outcomes between TyG T1 and T2 subgroups
Original publication
Synergistic effects of insulin resistance and revascularization completeness on prognosis in patients with coronary artery calcification. Cardiovasc Diabetol. Published 28 April 2026. doi:10.
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