The Relationship Between Triglyceride-glucose Index And Peri Procedural Adverse Cardiovascular Events After Percutaneous Coronary Intervention In Patients With Type2 Diabetes Mellitus And Acute Coronary Syndrome

BackgroundMany studies have established a relationship between triglycerideglucose index(TyG index)and prevalence,severity and prognosis of cardiovascular disease.However,the association between TyG index and peri-procedural outcomes in patients with type 2 diabetes mellitus and acute coronary syndromes is not known.Objectives1.To evaluate the relationship between triglyceride-glucoseindex,disease severity and periprocedural outcomes in patientsundergoing percutaneous coronary intervention.2.To evaluate the association of triglyceride-glucose indexand traditional cardiovascular risk factors.MethodsIn this study 813 patients(58.4% men,age: 67 ± 7.8 years;41.6%women,age: 67.6 ± 7.6 years)with type 2 diabetes mellitus and acute coronary syndromes who underwent PCI at the Second Affiliated Hospital of Dalian Medical University between January 2020 and December 2020 were retrospectively enrolled.Patients were divided into two groups according to sex.TyG index was calculated as ln(fasting triglyceride level [mg/d L] x fasting plasma glucose level [mg/d L]/2).The primary end point was all cause death,non-fatal stroke,unplanned repeat revascularization and periprocedural major adverse adverse cardiovascular events,the secondary end point including peri-procedural myocardial injury/infarction,acute kidney injury,new onset or worsening heart failure,new onset arrhythmias and bleeding complications(access site and non-access site).The association between TyG index and end point events was assessed by logistic regression analysis.ResultsA total of 813 patients(mean age: 67.2±7.7,41.6% women)were in this study.Among the participants,124(15.4%)had at least 1primary end point event.Primary end point events were 0(0%)Overall death,Non-fatal stroke and unplanned repeat revascularization.25(3.1%)Acute kidney injury,56(6.9%)post PCI heart failure,7(0.9%)bleeding complications,82(10.1%)post PCI Myocardial injury and 19(2.3%)post PCI arrhythmias.Among those who developed arrhythmias,11(57.9%)had PVCs,2(10.5%)had AF and 6(31.6%)had PACs.TyG index was not associated with primary end point in both male and female patients.TyG index as a continuous variable was associated with odds Ratio(OR)of 1.036(95% CI 0.738-1.456;P=0.837)in females and OR of 1.235(95%CI 0.879-1.965 P=0.182)in male patients.TyG index was significantly associated with acute kidney injury;OR 2.990(95%CI 1.584-5.642,P=<0.001)and post-PCI heart failure;OR 1.812(95%CI 1.156-2.842,P=0.010)but not with myocardial injury,bleeding or arrhythmias in female patients.In male patients,the index was not significantly associated with any of the secondary end points.ConclusionsTyG index was not significantly associated with primary end point but with secondary end point in women with T2 DM and ACS treated with PCI,suggesting that the TyG index may be a valuable predictor of peri-procedural major adverse cardiovascular events after PCI in women with T2 DM and ACS.