TyG and TyG-BMI indices predict major adverse cardiovascular events after emergency revascularization for acute myocardial infarction

doi:10.3969/j.issn.1004-583X.2026.01.002

Abstract

Abstract:

Objective To evaluate the predictive value of the triglyceride-glucose index (TyG) and the TyG-body mass index (BMI) index for the prognosis of patients with acute myocardial infarction (AMI) treated with emergency percutaneous coronary intervention (PCI). Methods We retrospectively analyzed 201 consecutive AMI patients who underwent emergency PCI to open the culprit vessel within 12 hours at the People's Hospital of Danyang between January 1, 2021 and December 31, 2022. Patients were classified by electrocardiogram (ECG) into non ST elevation myocardial infarction (NSTEMI) group(n=40) and ST elevation myocardial infarction (STEMI) group (n=161). Based on the cohort median TyG value, patients were dichotomized into below-median (Q1) group (n=100) and above-median (Q2) TyG group (n=101). Ninety-six contemporaneous patients with negative coronary angiography served as controls. Clinical and laboratory data, including TyG and TyG-BMI indices, were collected. Patients were followed for 24 months for occurrence of major adverse cardiovascular events (MACE). The predictive value of TyG and TyG-BMI indices for the prognosis of patients with AMI treated with emergency PCI was analyzed. Results Both NSTEMI and STEMI patients had higher TyG and TyG-BMI indices than controls (TyG: NSTEMI 9.16±0.72 and STEMI 9.46±0.69 vs control 8.66±0.50, both P<0.01; TyG-BMI: NSTEMI 241.04±39.49 and STEMI 255.50±44.45 vs control 212.74±33.27, both P<0.01). STEMI patients exhibited higher TyG and TyG-BMI than NSTEMI patients (9.46±0.69 vs 9.16±0.72,255.50±44.45 vs 241.04±39.49, P<0.05). TyG-BMI correlated positively with cardiac troponin I (cTnI; R=0.23, P<0.01), left ventricular end-diastolic diameter (LVDd; R=0.505, P<0.01), and Gensini score (R=0.44, P<0.01), and negatively with left ventricular ejection fraction (LVEF; R=-0.581, P<0.01). At 24 months, MACE incidence was higher in the NSTEMI and STEMI groups than in controls (P<0.05), and higher in the TyG above-median (Q2) group than the below-median (Q1) group (P<0.05). Kaplan-Meier analysis showed fewer MACE events among patients with lower TyG values. Conclusion The TyG and TyG-BMI indices show prognostic value for patients undergoing emergency PCI.

Key words: myocardial infarction, triglyceride glucose (TyG) index, triglyceride glucose body mass index (TyG-BMI), major adverse cardiac events

CLC Number:

R542.22

Ouyang Weili, Jiang Yile. TyG and TyG-BMI indices predict major adverse cardiovascular events after emergency revascularization for acute myocardial infarction[J]. Clinical Focus, 2026, 41(1): 12-17.

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Figures/Tables 7

References 23

[1]	Rao SV, O'Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI guideline for the management of patients with acute coronary syndromes: A report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines[J]. J Am Coll Cardiol, 2025, 85(22):2135-2237.doi: 10.1016/j.jacc.2025.03.500.
[2]	Bergmark BA, Mathenge N, Merlini PA, et al. Acute coronary syndromes[J]. Lancet, 2022, 399(10332):1347-1358.doi: 10.1016/S0140-6736(21)02391-6.
[3]	Moriwaki K, Kurita T, Hirota Y, et al. Prognostic impact of prehospital simple risk index in patients with ST-elevation myocardial infarction[J]. Circ J, 2023, 87(5):629-639.doi: 10.1253/circj.CJ-22-0795.
[4]	Gullick J, Wu J, Chew D, et al. Objective risk assessment vs standard care for acute coronary syndromes-The Australian GRACE Risk tool Implementation Study (AGRIS): A process evaluation[J]. BMC Health Serv Res, 2022, 22(1):380.doi: 10.1186/s12913-022-07750-8.
[5]	陈倩, 梁文琪, 赵茜, 等. TYG指数对慢性肾脏病患者新发心血管事件的预测价值[J]. 四川医学, 2022, 43(10):1023-1028. doi:10.16252/j.cnki.issn1004-0501-2022.10.013.
[6]	Li W, Shen C, Kong W, et al. Association between the triglyceride glucose-body mass index and future cardiovascular disease risk in a population with cardiovascular-kidney-metabolic syndrome stage 0-3: A nationwide prospective cohort study[J]. Cardiovasc Diabetol, 2024, 23(1):292.doi: 10.1186/s12933-024-02352-6.
[7]	Chen X, Wang L, Jiang Y, et al. Interplay between triglyceride-glucose index and cardiovascular events in hypertensive patients with controlled blood pressure (SBP<140 mmHg): Insights from the SPRINT trial[J]. Front Endocrinol (Lausanne), 2025, 16: 1508667.doi: 10.3389/fendo.2025.1508667.
[8]	Tai S, Fu L, Zhang N, et al. Impact of baseline and trajectory of triglyceride-glucose index on cardiovascular outcomes in patients with type 2 diabetes mellitus[J]. Front Endocrinol (Lausanne), 2022, 13:858209. doi: 10.3389/fendo.2022.858209.
[9]	Rampidis GP, Benetos G, Benz DC, et al. A guide for gensini score calculation[J]. Atherosclerosis, 2019, 287:181-183.doi: 10.1016/j.atherosclerosis.2019.05.012.
[10]	Kosmas CE, Bousvarou MD, Kostara CE, et al. Insulin resistance and cardiovascular disease[J]. J Int Med Res, 2023, 51(3):3000605231164548.doi: 10.1177/03000605231164548.
[11]	Siqueira de Andrade MI, Oliveira JS, Leal VS, et al. Independent predictors of insulin resistance in Brazilian adolescents: Results of the study of cardiovascular risk in adolescents-Brazil[J]. PloS one, 2021, 16(2):e0246445.doi: 10.1371/journal.pone.0246445.
[12]	DeFronzo RA, Tobin JD, Andres R. Glucose clamp technique: A method for quantifying insulin secretion and resistance[J]. Am J Physiol, 1979, 237(3):E214-23. doi: 10.1152/ajpendo.1979.237.3.E214.
[13]	Ramdas Nayak VK, Satheesh P, Shenoy MT, et al. Triglyceride glucose (TyG) index: A surrogate biomarker of insulin resistance[J]. J Pak Med Assoc, 2022, 72(5):986-988. doi: 10.47391/JPMA.22-63.
[14]	Tahapary DL, Pratisthita LB, Fitri NA, et al. Challenges in the diagnosis of insulin resistance: Focusing on the role of HOMA-IR and tryglyceride/glucose index[J]. Diabetes Metab Syndr, 2022, 16(8):102581. doi: 10.1016/j.dsx.2022.102581.
[15]	Cheng W, Kong F, Chen S. Comparison of the predictive value of four insulin resistance surrogates for the prevalence of hypertension: A population-based study[J]. Diabetol Metab Syndr, 2022, 14(1):137. doi: 10.1186/s13098-022-00907-9.
[16]	Wang J, Huang X, Fu C, et al. Association between triglyceride glucose index, coronary artery calcification and multivessel coronary disease in Chinese patients with acute coronary syndrome[J]. Cardiovasc Diabetol, 2022, 21(1):187.doi: 10.1186/s12933-022-01615-4.
[17]	Sun C, Hu L, Li X, et al. Triglyceride-glucose index's link to cardiovascular outcomes post-percutaneous coronary intervention in China: A meta-analysis[J]. ESC heart failure, 2024, 11(3):1317-1328.doi: 10.1002/ehf2.14679.
[18]	Liu M, Pan J, Meng K, et al. Triglyceride-glucose body mass index predicts prognosis in patients with ST-elevation myocardial infarction[J]. Sci Rep, 2024, 14(1):976. doi: 10.1038/s41598-023-51136-7.
[19]	Li F, Wang Y, Shi B, et al. Association between the cumulative average triglyceride glucose-body mass index and cardiovascular disease incidence among the middle-aged and older population: A prospective nationwide cohort study in China[J]. Cardiovasc Diabetol, 2024, 23(1):16. doi: 10.1186/s12933-023-02114-w.
[20]	Cersosimo E, DeFronzo RA. Insulin resistance and endothelial dysfunction: The road map to cardiovascular diseases[J]. Diabetes Metab Res Rev, 2006, 22(6):423-436. doi: 10.1002/dmrr.634.
[21]	Zamolodchikova TS, Tolpygo SM, Kotov AV. Insulin in the regulation of the renin-angiotensin system: A new perspective on the mechanism of insulin resistance and diabetic complications[J]. Front Endocrinol (Lausanne), 2024, 15:1293221. doi: 10.3389/fendo.2024.1293221.
[22]	Bays HE, Kirkpatrick CF, Maki KC, et al. Obesity, dyslipidemia, and cardiovascular disease: A joint expert review from the Obesity Medicine Association and the National Lipid Association 2024[J]. J Clin Lipidol, 2024, 18(3):e320-e350. doi: 10.1016/j.jacl.2024.04.001.
[23]	Powell-Wiley TM, Poirier P, Burke LE, et al. Obesity and cardiovascular disease: A scientific statement from the american heart association[J]. Circulation, 2021, 143(21):e984-e1010. doi: 10.1161/CIR.0000000000000973.

项目	对照组(n=96)	NSTEMI组(n=40)	STEMI组(n=161)	χ²/F/Z值	P值
年龄(岁)	61.06±9.02	59.10±11.58	61.16±11.92	0.584	0.558
男[例(%)]	43(44.79)	36(90.00)^*	121(75.16)^*	36.000	<0.01
高血压[例(%)]	63(65.63)	31(77.50)	117(72.67)	2.390	0.303
糖尿病[例(%)]	15(15.63)	10(25.00)	53(32.92)^*	9.330	<0.01
BMI(kg/m²)	24.53±3.42	26.28±3.40^*	26.91±3.62^*	13.800	<0.01
FBG(mmol/L)	5.31±1.33	6.83±2.57^*	7.55±3.76^*	16.480	<0.01
TG(mmol/L)	1.52±0.63	2.16±1.28^*	2.66±1.57^*#	23.40	<0.01
TyG指数	8.66±0.50	9.16±0.72^*	9.46±0.69^*#	47.420	<0.01
TyG-BMI指数	212.74±33.27	241.04±39.49^*	255.50±44.45^*#	33.560	<0.01
TC(mmol/L)	4.49±1.08	4.81±1.08	4.93±1.02^*	5.250	<0.01
LDL(mmol/L)	2.49±0.74	2.92±0.81^*	3.04±0.79^*	15.410	<0.01
HDL(mmol/L)	1.19±0.28	1.08±0.31^*	1.11±0.24^*	3.630	0.028
Cr(μmol/L)	63.23±15.32	71.29±13.61^*	71.74±20.77^*	6.880	<0.01
UA(μmol/L)	313.31±75.11	338.29±83.41	340.25±101.26	2.760	0.065
LVEF(%)	68.06±3.94	64.08±6.05^*	60.65±9.17^*#	29.880	<0.01
LVDd(mm)	47.25±4.87	50.00±4.61^*	50.57±6.05^*	11.130	<0.01
cTnI(μg/L)	0.01(0.00, 0.10)	23.20(8.78, 36.29)^*	35.90(24.91, 56.43)^*#	202.620	<0.01
NT-proBNP(ng/L)	-	765.97(321.00, 1720.23)	1095.25(448.27, 2110.86)	2669.000	0.105
Gensini评分(分)	1.67±1.98	78.85±20.89^*	87.87±18.05^*#	948.690	<0.01
Killip分级(Ⅰ/Ⅱ/Ⅲ/Ⅳ)	-	36/4/0/0	125/27/3/6	18.260	<0.01
MACE(24个月)[例(%)]	1(1.04)	5(12.50)^*	21(13.04)^*	9.540	<0.01

项目	对照组(n=96)	NSTEMI组(n=40)	STEMI组(n=161)	χ²/F/Z值	P值
年龄(岁)	61.06±9.02	59.10±11.58	61.16±11.92	0.584	0.558
男[例(%)]	43(44.79)	36(90.00)^*	121(75.16)^*	36.000	<0.01
高血压[例(%)]	63(65.63)	31(77.50)	117(72.67)	2.390	0.303
糖尿病[例(%)]	15(15.63)	10(25.00)	53(32.92)^*	9.330	<0.01
BMI(kg/m²)	24.53±3.42	26.28±3.40^*	26.91±3.62^*	13.800	<0.01
FBG(mmol/L)	5.31±1.33	6.83±2.57^*	7.55±3.76^*	16.480	<0.01
TG(mmol/L)	1.52±0.63	2.16±1.28^*	2.66±1.57^*#	23.40	<0.01
TyG指数	8.66±0.50	9.16±0.72^*	9.46±0.69^*#	47.420	<0.01
TyG-BMI指数	212.74±33.27	241.04±39.49^*	255.50±44.45^*#	33.560	<0.01
TC(mmol/L)	4.49±1.08	4.81±1.08	4.93±1.02^*	5.250	<0.01
LDL(mmol/L)	2.49±0.74	2.92±0.81^*	3.04±0.79^*	15.410	<0.01
HDL(mmol/L)	1.19±0.28	1.08±0.31^*	1.11±0.24^*	3.630	0.028
Cr(μmol/L)	63.23±15.32	71.29±13.61^*	71.74±20.77^*	6.880	<0.01
UA(μmol/L)	313.31±75.11	338.29±83.41	340.25±101.26	2.760	0.065
LVEF(%)	68.06±3.94	64.08±6.05^*	60.65±9.17^*#	29.880	<0.01
LVDd(mm)	47.25±4.87	50.00±4.61^*	50.57±6.05^*	11.130	<0.01
cTnI(μg/L)	0.01(0.00, 0.10)	23.20(8.78, 36.29)^*	35.90(24.91, 56.43)^*#	202.620	<0.01
NT-proBNP(ng/L)	-	765.97(321.00, 1720.23)	1095.25(448.27, 2110.86)	2669.000	0.105
Gensini评分(分)	1.67±1.98	78.85±20.89^*	87.87±18.05^*#	948.690	<0.01
Killip分级(Ⅰ/Ⅱ/Ⅲ/Ⅳ)	-	36/4/0/0	125/27/3/6	18.260	<0.01
MACE(24个月)[例(%)]	1(1.04)	5(12.50)^*	21(13.04)^*	9.540	<0.01

项目	Q1组(n=101)	Q2组(n=100)	χ²/F/Z值	P值
年龄(岁)	62.58±11.80	58.89±11.68	4.980	0.027
男[例(%)]	81(80.20)	76(76.00)	0.520	0.472
高血压[例(%)]	71(70.30)	77(77.00)	1.160	0.281
糖尿病[例(%)]	18(17.82)	45(45.00)	17.250	<0.01
BMI(kg/m²)	25.94±3.22	27.64±3.73	12.020	<0.01
FBG(mmol/L)	6.20±1.83	8.63±4.39	26.340	<0.01
TG(mmol/L)	1.58±0.46	3.55±1.58	145.060	<0.01
TyG指数	8.88±0.35	9.93±0.56	255.020	<0.01
TyG-BMI指数	230.48±30.93	274.98±43.62	69.710	<0.01
TC(mmol/L)	4.75±1.00	5.06±1.04	4.790	0.030
LDL(mmol/L)	2.93±0.79	3.10±0.79	2.300	0.131
HDL(mmol/L)	1.10±0.25	1.10±0.26	0.100	0.920
Cr(μmol/L)	72.19±20.10	71.11±19.03	0.150	0.697
UA(μmol/L)	339.86±96.88	339.85±99.16	0.000	0.999
cTnI(μg/L)	24.91(20.28, 49.48)	42.30(24.91, 66.66)	3864.50	<0.01
NT-proBNP(ng/L)	1 089.92(400.25, 2 253.44)	972.23(375.75, 1 866.53)	4320.56	0.172
LVEF(%)	64.62±4.82	58.00±10.41	36.640	<0.01
LVDd(mm)	48.78±4.05	52.14±6.73	18.410	<0.01
Gensini评分(分)	80.22±18.30	91.99±17.77	21.380	<0.01
MACE[例(%)]	8(7.92)	18(18.00)	4.530	0.033

项目	Q1组(n=101)	Q2组(n=100)	χ²/F/Z值	P值
年龄(岁)	62.58±11.80	58.89±11.68	4.980	0.027
男[例(%)]	81(80.20)	76(76.00)	0.520	0.472
高血压[例(%)]	71(70.30)	77(77.00)	1.160	0.281
糖尿病[例(%)]	18(17.82)	45(45.00)	17.250	<0.01
BMI(kg/m²)	25.94±3.22	27.64±3.73	12.020	<0.01
FBG(mmol/L)	6.20±1.83	8.63±4.39	26.340	<0.01
TG(mmol/L)	1.58±0.46	3.55±1.58	145.060	<0.01
TyG指数	8.88±0.35	9.93±0.56	255.020	<0.01
TyG-BMI指数	230.48±30.93	274.98±43.62	69.710	<0.01
TC(mmol/L)	4.75±1.00	5.06±1.04	4.790	0.030
LDL(mmol/L)	2.93±0.79	3.10±0.79	2.300	0.131
HDL(mmol/L)	1.10±0.25	1.10±0.26	0.100	0.920
Cr(μmol/L)	72.19±20.10	71.11±19.03	0.150	0.697
UA(μmol/L)	339.86±96.88	339.85±99.16	0.000	0.999
cTnI(μg/L)	24.91(20.28, 49.48)	42.30(24.91, 66.66)	3864.50	<0.01
NT-proBNP(ng/L)	1 089.92(400.25, 2 253.44)	972.23(375.75, 1 866.53)	4320.56	0.172
LVEF(%)	64.62±4.82	58.00±10.41	36.640	<0.01
LVDd(mm)	48.78±4.05	52.14±6.73	18.410	<0.01
Gensini评分(分)	80.22±18.30	91.99±17.77	21.380	<0.01
MACE[例(%)]	8(7.92)	18(18.00)	4.530	0.033