Background
Methods
Study population
Grouping
Laboratory investigations
Percutaneous coronary intervention
Endpoints and definitions
Statistical analysis
Results
Patient characteristics
Variable | Q1 (n = 273) | Q2 (n = 273) | Q3 (n = 273) | Q4 (n = 273) | P value |
---|---|---|---|---|---|
TyG index | 8.373 ± 0.258 | 8.905 ± 0.122 | 9.345 ± 0.145 | 10.076 ± 0.483 | < 0.001 |
Age, years | 65.2 ± 13.2 | 63.5 ± 10.8 | 61.2 ± 11.6 | 57.6 ± 12.4 | < 0.001 |
Male | 219 (80.2) | 220 (80.6) | 222 (81.3) | 213 (78.0) | 0.546 |
BMI, kg/m2 | 25.2 (24.7–25.5) | 25.5 (25.1–25.8) | 26.0 (25.6–26.2) | 26.5 (26.0–26.9) | 0.012 |
SBP, mmHg | 124.9 ± 22.1 | 128.7 ± 21.9 | 129.9 ± 20.8 | 138.3 ± 22.6 | < 0.001 |
DBP, mmHg | 75.2 ± 14.1 | 76.6 ± 13.4 | 77.1 ± 14.3 | 84.7 ± 16.8 | < 0.001 |
Heart rate, bpm | 77.7 ± 14.5 | 79.7 ± 13.1 | 79.0 ± 12.7 | 82.2 ± 16.3 | 0.019 |
Killip class > 1 | 82 (30.3) | 85 (31.1) | 91 (33.3) | 89 (32.6) | 0.523 |
Smoker | 114 (41.8) | 120 (44.0) | 123 (45.1) | 126 (46.2) | 0.886 |
Hypertension | 138 (50.5) | 162 (60.0) | 177 (64.8) | 201 (73.6) | < 0.001 |
Diabetes mellitus | 21 (7.7) | 45 (16.5) | 81 (29.7) | 123 (45.1) | < 0.001 |
Anemia | 33 (12.1) | 26 (9.5) | 30 (11.0) | 35 (12.8) | 0.322 |
Previous AMI | 6 (2.2) | 6 (2.2) | 7 (2.6) | 8 (2.9) | 0.489 |
Atrial fibrillation | 16 (5.8) | 13 (4.8) | 17 (6.2) | 15 (5.5) | 0.652 |
Biochemical indicators | |||||
NT-proBNP, pg/mL (IQR) | 525.5 (31.0–2193.2) | 534.4 (53.5–2293.7) | 527.6 (34.9–2401.4) | 546 (71.2–2603.2) | 0.179 |
Cardiac troponin I, ng/ml (IQR) | 12.2 (3.01–22.7) | 11.6 (2.7–23.1) | 13.1 (2.3–23.9) | 12.7 (2.6–24.2) | 0.762 |
hs-CRP, mg/L (IQR) | 7.9 (5.5–10.4) | 7.3 (4.4–11.1) | 6.9 (3.9–9.7) | 7.3 (3.4–10.7) | 0.652 |
White blood cells, 109/L | 9.9 ± 3.9 | 10.0 ± 3.9 | 10.0 ± 3.2 | 10.2 ± 3.2 | 0.826 |
Neutrophil ratio | 75.5 ± 10.3 | 76.2 ± 11.4 | 75.2 ± 13.6 | 75.9 ± 12.9 | 0.775 |
Platelet, 109/L | 195.0 ± 56.1 | 201.8 ± 60.5 | 228.8 ± 63.0 | 223.8 ± 53.9 | < 0.001 |
Albumin, g/L | 36.1 ± 4.8 | 37.3 ± 4.1 | 37.6 ± 4.5 | 38.2 ± 5.2 | 0.022 |
FPG, mmol/L | 6.6 ± 1.9 | 7.1 ± 1.8 | 8.1 ± 2.4 | 11.7 ± 6.0 | < 0.001 |
Measured HbA1c, % (IQR) | 6.5 (6.2–6.8) | 7.1 (6.9–7.4) | 7.6 (7.5–7.8) | 8.0 (7.9–8.2) | < 0.001 |
TC, mmol/L | 4.0 ± 0.9 | 4.3 ± 1.0 | 4.8 ± 1.2 | 5.2 ± 1.3 | < 0.001 |
Triglycerides, mmol/L | 0.9 ± 0.3 | 1.4 ± 0.3 | 1.9 ± 0.6 | 3.6 ± 2.6 | < 0.001 |
HDL-C, mmol/L | 1.0 ± 0.3 | 1.1 ± 0.2 | 1.2 ± 0.3 | 1.2 ± 0.3 | < 0.001 |
LDL-C, mmol/L | 2.4 ± 0.7 | 2.7 ± 0.8 | 3.0 ± 1.0 | 3.1 ± 0.8 | < 0.001 |
Uric acid, umol/L | 319.5 ± 102.6 | 325.5 ± 87.3 | 342.2 ± 109.3 | 347.4 ± 100.6 | 0.019 |
eGFR, mL/min | 87.0 ± 32.8 | 85.4 ± 42.0 | 86.9 ± 34.3 | 89.5 ± 39.1 | 0.423 |
Coronary angiography | |||||
GPIIb/IIIa antagonists | 91 (33.3) | 89 (32.6) | 86 (31.8) | 92 (33.7) | 0.644 |
Anticoagulation | 25 (9.2) | 27 (9.9) | 22 (8.1) | 24 (8.8) | 0.546 |
Lesion vessels | 3.2 ± 1.6 | 3.2 ± 1.5 | 3.0 ± 1.8 | 3.1 ± 1.3 | 0.743 |
Three-vessel disease | 105 (38.5) | 138 (50.5) | 150 (54.9) | 168 (61.5) | < 0.001 |
Number of stents | 1.03 ± 0.54 | 1.02 ± 0.47 | 1.02 ± 0.45 | 1.11 ± 0.50 | 0.114 |
Gensini score, (IQR) | 61.6 (49.3–75.7) | 65.4 (54.1–72.6) | 71.6 (60.9–79.3) | 78.3 (63.1–83.9) | 0.049 |
Echocardiography | |||||
LVEF | 0.55 ± 0.12 | 0.54 ± 0.10 | 0.56 ± 0.10 | 0.55 ± 0.12 | 0.335 |
Medications use at discharge | |||||
Aspirin | 255 (93.4) | 264 (96.7) | 264 (96.7) | 267 (97.8) | 0.059 |
Clopidogrel/Ticagrelor | 267 (97.8) | 270 (98.9) | 267 (97.8) | 273 (100) | 0.082 |
Statin | 261 (95.6) | 265 (97.1) | 267 (97.8) | 260 (95.2) | 0.321 |
Beta blockers | 215 (78.8) | 228 (83.5) | 210 (76.4) | 223 (81.1) | 0.247 |
ACEI/ARB | 168 (61.1) | 180 (65.5) | 171 (62.2) | 183 (66.5) | 0.205 |
Risk factors for MACCEs
Variable | MACCE group (n = 375) | MACCE-free group (n = 717) | P value |
---|---|---|---|
Age, years | 64.5 ± 12.5 | 61.3 ± 12.4 | < 0.001 |
Male | 300 (80.0) | 564 (78.7) | 0.638 |
BMI, kg/m2 | 25.3 ± 2.1 | 25.1 ± 2.4 | 0.382 |
SBP, mmHg | 128.7 ± 18.9 | 128.8 ± 22.7 | 0.939 |
DBP, mmHg | 76.1 ± 13.9 | 78.0 ± 14.1 | 0.028 |
Heart rate, bpm | 79.5 ± 15.4 | 79.7 ± 14.5 | 0.905 |
Killip class > 1 | 142 (37.9) | 210 (29.3) | < 0.001 |
Smoker | 199 (53.1) | 317 (44.2) | 0.012 |
Hypertension | 261 (69.6) | 417 (58.2) | < 0.001 |
Diabetes mellitus | 117 (31.2) | 153 (21.3) | < 0.001 |
Anemia | 67 (17.9) | 74 (10.3) | 0.023 |
Previous AMI | 9 (2.4) | 15 (2.1) | 0.447 |
Atrial fibrillation | 15 (4.0) | 33 (4.6) | 0.385 |
Biochemical indicators | |||
NT-proBNP, pg/mL (IQR) | 525.5 (31.0–2193.2) | 546.8 (71.2–2603.2) | 0.179 |
Cardiac troponin I, ng/ml | 13.1 (3.18–23.5) | 12.7 (2.8–23.2) | 0.480 |
hs-CRP, mg/L (IQR) | 7.6 (4.6–9.8) | 7.1 (3.2–10.1) | 0.152 |
White blood cells, 109/L | 10.4 ± 3.6 | 9.9 ± 3.4 | 0.046 |
Neutrophil ratio | 75.6 ± 12.8 | 75.8 ± 11.8 | 0.680 |
Platelet, 109/L | 217.2 ± 68.6 | 208.4 ± 56.8 | 0.024 |
Albumin, g/L | 36.4 ± 5.7 | 37.1 ± 4.5 | 0.021 |
FPG, mmol/L | 9.0 ± 4.2 | 8.3 ± 4.4 | 0.008 |
Measured HbA1c, % | 7.8 ± 1.3 | 7.3 ± 1.4 | 0.010 |
TC, mmol/L | 4.6 ± 1.4 | 4.6 ± 1.1 | 0.781 |
Triglycerides, mmol/L | 1.9 ± 1.6 | 1.9 ± 1.4 | 0.502 |
HDL-C, mmol/L | 1.1 ± 0.3 | 1.1 ± 0.2 | 0.417 |
LDL-C, mmol/L | 2.8 ± 0.9 | 2.9 ± 0.8 | 0.412 |
Uric acid, umol/L | 342.3 ± 112.2 | 321.6 ± 100.3 | 0.002 |
eGFR, mL/min | 79.4 ± 36.7 | 86.5 ± 37.4 | 0.008 |
Coronary angiography | |||
GPIIb/IIIa antagonists | 121 (33.8) | 237 (33.0) | 0.515 |
Anticoagulation | 33 (8.8) | 65 (9.1) | 0.482 |
Lesion vessels | 3.3 ± 1.5 | 2.9 ± 1.5 | < 0.001 |
Three-vessel disease | 213 (56.8) | 348 (48.5) | < 0.001 |
Number of stents | 1.0 ± 0.49 | 1.12 ± 0.50 | < 0.001 |
Gensini score, (IQR) | 73.1 (45.3–94.8) | 67.0 (36.3–89.8) | 0.035 |
Echocardiography | |||
LVEF | 0.53 ± 0.12 | 0.55 ± 0.11 | 0.037 |
Medications use at discharge | |||
Aspirin | 357 (95.2) | 693 (96.7) | 0.154 |
Clopidogrel/Ticagrelor | 369 (98.4) | 708 (98.7) | 0.414 |
Statin | 366 (97.6) | 687 (95.8) | 0.088 |
Beta blockers | 301 (80.3) | 576 (80.3) | 0.477 |
ACEI/ARB | 240 (64.0) | 462 (64.4) | 0.469 |
Variable | Univariate analysis | Multivariate analysis | ||||
---|---|---|---|---|---|---|
OR | 95% CI | P value | OR | 95% CI | P value | |
TyG index grouping | ||||||
Q1 | 1 | 1 | ||||
Q2 | 1.096 | 0.778–1.545 | 0.600 | 1.117 | 0.668–1.843 | 0.587 |
Q3 | 1.542 | 1.083–2.194 | 0.016 | 1.356 | 0.852–2.160 | 0.199 |
Q4 | 1.809 | 1.263–2.590 | 0.001 | 1.529 | 1.001–2.061 | 0.003 |
Age, years | 1.021 | 1.011–1.032 | < 0.001 | 1.011 | 0.992–1.031 | 0.233 |
Male | 0.922 | 0.676–1.256 | 0.605 | |||
BMI, kg/m2 | 1.005 | 0.950–1.043 | 0.460 | |||
SBP, mmHg | 1.001 | 0.994–1.006 | 0.839 | |||
DBP, mmHg | 0.990 | 0.981–0.999 | 0.029 | 0.993 | 0.982–1.005 | 0.258 |
Heart rate, bpm | 0.999 | 0.991–1.008 | 0.905 | |||
Killip class > 1 | 2.188 | 1.667–2.874 | < 0.001 | 1.722 | 1.185–2.471 | 0.002 |
Smoker | 1.347 | 1.047–1.733 | 0.020 | 1.191 | 0.858–1.653 | 0.297 |
Hypertension | 1.631 | 1.250–2.127 | < 0.001 | |||
Diabetes mellitus | 1.672 | 1.261–2.216 | < 0.001 | |||
Anemia | 1.351 | 0.940–1.941 | < 0.001 | 1.282 | 0.995–1.563 | 0.024 |
Previous AMI | 1.151 | 0.499–2.655 | 0.742 | |||
Atrial fibrillation | 0.864 | 0.463–1.611 | 0.645 | |||
Biochemical indicators | ||||||
NT-proBNP, pg/mL (IQR) | 1.057 | 0.909–1.158 | 0.770 | |||
Cardiac troponin I, ng/ml | 1.018 | 0.830–1.257 | 0.571 | |||
hs-CRP, mg/L (IQR) | 1.026 | 0.975–1.074 | 0.302 | |||
White blood cells, 109/L | 1.037 | 1.001–1.075 | 0.047 | 1.038 | 0.988–1.091 | 0.141 |
Neutrophil ratio | 0.998 | 0.988–1.008 | 0.680 | |||
Platelet, 109/L | 1.002 | 1.000–1.004 | 0.025 | 1.002 | 0.999–1.004 | 0.285 |
Albumin, g/L | 0.971 | 0.947–0.996 | 0.023 | 0.963 | 0.928–1.000 | 0.050 |
Measured HbA1c, % | 1.173 | 1.042–1.321 | 0.005 | |||
FPG, mmol/L | 1.040 | 1.010–1.072 | 0.009 | |||
TC, mmol/L | 1.015 | 0.916–1.124 | 0.781 | |||
Triglycerides, mmol/L | 1.021 | 0.909–1.131 | 0.503 | |||
HDL-C, mmol/L | 0.813 | 0.494–1.339 | 0.813 | |||
LDL-C, mmol/L | 0.938 | 0.806–1.092 | 0.412 | |||
Uric acid, umol/L | 1.002 | 1.001–1.003 | 0.002 | 1.002 | 1.000–1.004 | 0.013 |
eGFR, mL/min | 0.995 | 0.991–0.999 | 0.009 | 0.999 | 0.993–1.005 | 0.751 |
Coronary angiography | ||||||
GPIIb/IIIa antagonists | 0.910 | 0.703–1.176 | 0.470 | |||
Anticoagulation | 1.406 | 0.773–2.557 | 0.264 | |||
Lesion vessels | 1.163 | 1.071–1.263 | < 0.001 | 1.092 | 0.960–1.243 | 0.180 |
Three-vessel disease | 1.394 | 1.084–1.793 | 0.010 | 1.244 | 0.830–1.865 | 0.289 |
Number of stents | 1.575 | 1.220–2.032 | < 0.001 | 1.709 | 1.229–2.375 | 0.001 |
Gensini score | 1.008 | 1.002–1.017 | 0.022 | 1.002 | 0.993–1.010 | 0.366 |
LVEF | 0.303 | 0.099–0.931 | 0.037 | 0.121 | 0.029–0.057 | 0.004 |
Medications use at discharge | ||||||
Aspirin | 0.687 | 0.368–1.282 | 0.238 | |||
Clopidogrel/ticagrelor | 0.782 | 0.276–2.213 | 0.643 | |||
Statin | 1.776 | 0.834–3.781 | 0.136 | |||
Beta blockers | 0.979 | 0.716–1.339 | 0.895 | |||
ACEI/ARB | 1.208 | 0.917–1.590 | 0.179 |
Unstandardized coefficients | Standardized coefficients | t | Sig. | Collinearity statistics | |||
---|---|---|---|---|---|---|---|
B | Std. error | Beta | Tolerance | VIF | |||
(Constant) | 6.683 | 0.356 | 18.758 | 0.000 | |||
Age, years | − 0.006 | 0.002 | − 0.100 | − 2.406 | 0.016 | 0.424 | 2.361 |
DBP, mmHg | 0.005 | 0.001 | 0.098 | 3.231 | 0.001 | 0.801 | 1.248 |
Killip class > 1 | − 0.080 | 0.056 | − 0.044 | − 1.415 | 0.157 | 0.754 | 1.325 |
Smoker | 0.094 | 0.043 | 0.066 | 2.184 | 0.029 | 0.803 | 1.245 |
Hypertension | 0.066 | 0.063 | 0.206 | 1.050 | 0.298 | 0.097 | 10.331 |
Diabetes mellitus | 0.287 | 0.371 | 0.207 | 0.772 | 0.444 | 0.052 | 19.393 |
Anemia | − 0.041 | 0.066 | − 0.018 | − 0.617 | 0.538 | 0.824 | 1.214 |
White blood cells | − 0.012 | 0.006 | − 0.061 | − 1.931 | 0.054 | 0.741 | 1.349 |
Platelet | 0.001 | 0.003 | 0.111 | 3.700 | 0.000 | 0.861 | 1.225 |
Albumin | 0.021 | 0.005 | 0.137 | 4.461 | 0.000 | 0.861 | 1.225 |
Measured HbA1c | − 0.053 | 0.024 | − 0.447 | − 2.167 | 0.035 | 0.087 | 11.464 |
FPG | 0.545 | 0.098 | 1.083 | 5.576 | 0.000 | 0.098 | 10.171 |
Uric acid | 0.031 | 0.015 | 0.065 | 2.245 | 0.025 | 0.864 | 1.157 |
eGFR | 0.002 | 0.001 | 0.116 | 2.970 | 0.003 | 0.475 | 2.106 |
Lesion vessels | − 0.015 | 0.017 | − 0.033 | − 0.900 | 0.368 | 0.551 | 1.814 |
three-vessel disease | 0.118 | 0.052 | 0.082 | 2.283 | 0.023 | 0.560 | 1.787 |
Number of stents | 0.087 | 0.006 | 0.482 | 4.721 | 0.002 | 0.682 | 1.160 |
Gensini score | 0.074 | 0.030 | 0.293 | 2.456 | 0.018 | 0.260 | 3.848 |
LVEF | 0.508 | 0.186 | 0.080 | 2.733 | 0.006 | 0.862 | 1.160 |
Variables | TyG index | |||
---|---|---|---|---|
Male | Female | DM | Non-DM | |
AUC (95% CI) | 0.705 (0.618–0.796) | 0.654 (0.588–0.679) | 0.699 (0.613–0.785) | 0.678 (0.611–0.746) |
P value | 0.008 | 0.019 | 0.001 | 0.015 |
Variables | AUC (95% CI) | P value |
---|---|---|
FPG | 0.642 (0.546–0.738) | 0.011 |
TG | 0.549 (0.483–0.614) | 0.217 |
TyG index | 0.685 (0.610–0.761) | 0.001 |