Title : Triglyceride-glucose index for predicting repeat revascularization and instent restenosis in patients with chronic coronary syndrome undergoing percutaneous coronary intervention
Background: The triglyceride-glucose (TyG) index, a reliable surrogate indicator of insulin resistance, is demonstrated independently associated with coronary artery disease of various clinical manifestations. This study aimed to investigate the prognostic value of the TyG index in predicting repeat revascularization and in-stent restenosis (ISR) in chronic coronary syndrome (CCS) patients undergoing percutaneous coronary intervention (PCI). Methods: A total of 1414 participants were enrolled and divided into groups according to the tertiles of the TyG index. The primary endpoint was a composite of PCI complications including repeat revascularization and ISR. The associations between the TyG index and the primary endpoint was assessed by multivariable Cox proportional hazards regression analysis with restricted cubic splines. The TyG index was calculated as Ln (fasting triglycerides (mg/dL)?fasting plasma glucose (mg/dL)/2). Results: Over a median follow-up of 60 months, 548 (38.76%) patients had experienced at least 1 primary endpoint event. The follow-up incidence of primary endpoint increased with the TyG index tertiles. After adjusting for potential cofounders, the TyG index was independently associated with the primary endpoint in CCS patients (HR, 1.191; 95%CI, 1.038-1.367; P = 0.013). Additionally, the highest tertile of the TyG group was correlated with a 1.319-fold risk of the primary endpoint compared with the lowest tertile of the TyG group (HR, 1.319; 95% CI, 1.063-1.637; P = 0.012). Furthermore, a linear and dose-response relationship was observed between the TyG index and the primary endpoint (non-linear P = 0.373, P overall = 0.035). Conclusions: An increased TyG index was associated with elevated risk for long-term PCI complications including repeat revascularization and ISR. Our study suggested that the TyG index could be used as a potent predictor in evaluating the prognosis of CCS patients undergoing PCI.