Association of triglyceride-glucose index with in-hospital outcomes in patients with acute myocardial infarction: a retrospective, single-centre, cohort study in China.

Abstract

To investigate the association between triglyceride-glucose (TyG) index levels at hospital admission and the risk of in-hospital adverse events, including all-cause mortality, in patients with acute myocardial infarction (AMI). The primary hypothesis was that higher TyG index levels are associated with greater risk of adverse in-hospital outcomes. Retrospective cohort study. Tertiary hospital inpatient care in China. The study included consecutively hospitalised patients with AMI between 1 August 2011 and 10 January 2022. A total of 3458 patients with AMI were included. The mean age was 60.8 years, and 78.4% were men. Patients were excluded if they had incomplete data for TyG index calculation or outcome ascertainment. No therapeutic intervention was assigned; the study was observational. TyG index was calculated using fasting triglycerides and fasting plasma glucose levels at admission. The primary outcome was all-cause in-hospital mortality. Secondary outcomes included cardiogenic shock and fatal rapid arrhythmia. Outcomes were identified through standardised clinical records. Among 3458 patients, 375 (10.84%) died during hospitalisation, 236 (6.84%) developed cardiogenic shock and 147 (4.25%) experienced fatal rapid arrhythmia. After multivariable adjustment, higher TyG index levels were significantly associated with increased odds of all-cause mortality (OR, 1.27; 95% CI, 1.02 to 1.57; p<0.05) and cardiogenic shock (OR, 1.54; 95% CI, 1.22 to 1.94; p<0.001). When categorised into quartiles, patients in the highest quartile (Q4) had greater odds of mortality (OR, 1.71; 95% CI, 1.10 to 2.65; p<0.05) and cardiogenic shock (Q2: OR, 2.18; 95% CI, 1.39 to 3.45; Q3: OR, 1.71; 95% CI, 1.06 to 2.77; Q4: OR, 2.81; 95% CI, 1.70 to 4.67; all p<0.05 vs Q1). Restricted cubic spline analysis confirmed a linear association between the TyG index and both primary and secondary outcomes. Higher TyG index levels at admission are independently associated with an increased risk of all-cause mortality and cardiogenic shock among patients hospitalised for AMI. These findings suggest that the TyG index may serve as a useful prognostic biomarker for risk stratification in this population. Further prospective studies are warranted to validate its clinical utility.