Association between triglyceride glucose-body mass index and long-term adverse outcomes of heart failure patients with coronary heart disease

Cardiovasc Diabetol. 2024 May 9;23(1):162. doi: 10.1186/s12933-024-02213-2.

Abstract

Background: The triglyceride glucose-body mass index (TyG-BMI) is recognized as a reliable surrogate for evaluating insulin resistance and an effective predictor of cardiovascular disease. However, the link between TyG-BMI index and adverse outcomes in heart failure (HF) patients remains unclear. This study examines the correlation of the TyG-BMI index with long-term adverse outcomes in HF patients with coronary heart disease (CHD).

Methods: This single-center, prospective cohort study included 823 HF patients with CHD. The TyG-BMI index was calculated as follows: ln [fasting triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2] × BMI. To explore the association between the TyG-BMI index and the occurrences of all-cause mortality and HF rehospitalization, we utilized multivariate Cox regression models and restricted cubic splines with threshold analysis.

Results: Over a follow-up period of 9.4 years, 425 patients died, and 484 were rehospitalized due to HF. Threshold analysis revealed a significant reverse "J"-shaped relationship between the TyG-BMI index and all-cause mortality, indicating a decreased risk of all-cause mortality with higher TyG-BMI index values below 240.0 (adjusted model: HR 0.90, 95% CI 0.86-0.93; Log-likelihood ratio p = 0.003). A distinct "U"-shaped nonlinear relationship was observed with HF rehospitalization, with the inflection point at 228.56 (adjusted model: below: HR 0.95, 95% CI 0.91-0.98; above: HR 1.08, 95% CI 1.03-1.13; Log-likelihood ratio p < 0.001).

Conclusions: This study reveals a nonlinear association between the TyG-BMI index and both all-cause mortality and HF rehospitalization in HF patients with CHD, positioning the TyG-BMI index as a significant prognostic marker in this population.

Keywords: All-cause mortality; Heart failure; Heart failure rehospitalization; Nonlinear association; Triglyceride glucose-body mass index.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers* / blood
  • Blood Glucose* / metabolism
  • Body Mass Index*
  • Cause of Death
  • Coronary Disease* / blood
  • Coronary Disease* / diagnosis
  • Coronary Disease* / epidemiology
  • Coronary Disease* / mortality
  • Female
  • Heart Failure* / blood
  • Heart Failure* / diagnosis
  • Heart Failure* / mortality
  • Humans
  • Insulin Resistance
  • Male
  • Middle Aged
  • Patient Readmission*
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Triglycerides* / blood

Substances

  • Triglycerides
  • Blood Glucose
  • Biomarkers