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Triglyceride-glucose index is associated with the occurrence and prognosis of cardiac arrest: a multicenter retrospective observational study

BACKGROUND: Triglyceride-glucose (TyG) index is an efficient indicator of insulin resistance and is proven to be a valuable marker in several cardiovascular diseases. However, the relationship between TyG index and cardiac arrest (CA) remains unclear. The present study aimed to investigate the assoc...

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Autores principales: Boshen, Yang, Yuankang, Zhu, Xinjie, Zheng, Taixi, Li, kaifan, Niu, Zhixiang, Wang, Juan, Song, Junli, Duan, Suiji, Li, Xia, Lu, Chengxing, Shen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10375765/
https://www.ncbi.nlm.nih.gov/pubmed/37501144
http://dx.doi.org/10.1186/s12933-023-01918-0
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author Boshen, Yang
Yuankang, Zhu
Xinjie, Zheng
Taixi, Li
kaifan, Niu
Zhixiang, Wang
Juan, Song
Junli, Duan
Suiji, Li
Xia, Lu
Chengxing, Shen
author_facet Boshen, Yang
Yuankang, Zhu
Xinjie, Zheng
Taixi, Li
kaifan, Niu
Zhixiang, Wang
Juan, Song
Junli, Duan
Suiji, Li
Xia, Lu
Chengxing, Shen
author_sort Boshen, Yang
collection PubMed
description BACKGROUND: Triglyceride-glucose (TyG) index is an efficient indicator of insulin resistance and is proven to be a valuable marker in several cardiovascular diseases. However, the relationship between TyG index and cardiac arrest (CA) remains unclear. The present study aimed to investigate the association of the TyG index with the occurrence and clinical outcomes of CA. METHODS: In this retrospective, multicenter, observational study, critically ill patients, including patients post-CA, were identified from the eICU Collaborative Research Database and evaluated. The TyG index for each patient was calculated using values of triglycerides and glucose recorded within 24 h of intensive care unit (ICU) admission. In-hospital mortality and ICU mortality were the primary clinical outcomes. Logistic regression, restricted cubic spline (RCS), and correlation analyses were performed to explore the relationship between the TyG index and clinical outcomes. Propensity score matching (PSM), overlap weighting (OW), and inverse probability of treatment weighting (IPTW) were adopted to balance the baseline characteristics of patients and minimize selection bias to confirm the robustness of the results. Subgroup analysis based on different modifiers was also performed. RESULTS: Overall, 24,689 critically ill patients, including 1021 patients post-CA, were enrolled. The TyG index was significantly higher in patients post-CA than in those without CA (9.20 (8.72–9.69) vs. 8.89 (8.45–9.41)), and the TyG index had a moderate discrimination ability to identify patients with CA from the overall population (area under the curve = 0.625). Multivariate logistic regression indicated that the TyG index was an independent risk factor for in-hospital mortality (OR = 1.28, 95% CI: 1.03–1.58) and ICU mortality (OR = 1.27, 95% CI: 1.02–1.58) in patients post-CA. RCS curves revealed that an increased TyG index was linearly related to higher risks of in-hospital and ICU mortality (P for nonlinear: 0.225 and 0.271, respectively). Even after adjusting by PSM, IPTW, and OW, the TyG index remained a risk factor for in-hospital mortality and ICU mortality in patients experiencing CA, which was independent of age, BMI, sex, etc. Correlation analyses revealed that TyG index was negatively correlated with the neurological status of patients post-CA. CONCLUSION: Elevated TyG index is significantly associated with the occurrence of CA and higher mortality risk in patients post-CA. Our findings extend the landscape of TyG index in cardiovascular diseases, which requires further prospective cohort study. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12933-023-01918-0.
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spelling pubmed-103757652023-07-29 Triglyceride-glucose index is associated with the occurrence and prognosis of cardiac arrest: a multicenter retrospective observational study Boshen, Yang Yuankang, Zhu Xinjie, Zheng Taixi, Li kaifan, Niu Zhixiang, Wang Juan, Song Junli, Duan Suiji, Li Xia, Lu Chengxing, Shen Cardiovasc Diabetol Research BACKGROUND: Triglyceride-glucose (TyG) index is an efficient indicator of insulin resistance and is proven to be a valuable marker in several cardiovascular diseases. However, the relationship between TyG index and cardiac arrest (CA) remains unclear. The present study aimed to investigate the association of the TyG index with the occurrence and clinical outcomes of CA. METHODS: In this retrospective, multicenter, observational study, critically ill patients, including patients post-CA, were identified from the eICU Collaborative Research Database and evaluated. The TyG index for each patient was calculated using values of triglycerides and glucose recorded within 24 h of intensive care unit (ICU) admission. In-hospital mortality and ICU mortality were the primary clinical outcomes. Logistic regression, restricted cubic spline (RCS), and correlation analyses were performed to explore the relationship between the TyG index and clinical outcomes. Propensity score matching (PSM), overlap weighting (OW), and inverse probability of treatment weighting (IPTW) were adopted to balance the baseline characteristics of patients and minimize selection bias to confirm the robustness of the results. Subgroup analysis based on different modifiers was also performed. RESULTS: Overall, 24,689 critically ill patients, including 1021 patients post-CA, were enrolled. The TyG index was significantly higher in patients post-CA than in those without CA (9.20 (8.72–9.69) vs. 8.89 (8.45–9.41)), and the TyG index had a moderate discrimination ability to identify patients with CA from the overall population (area under the curve = 0.625). Multivariate logistic regression indicated that the TyG index was an independent risk factor for in-hospital mortality (OR = 1.28, 95% CI: 1.03–1.58) and ICU mortality (OR = 1.27, 95% CI: 1.02–1.58) in patients post-CA. RCS curves revealed that an increased TyG index was linearly related to higher risks of in-hospital and ICU mortality (P for nonlinear: 0.225 and 0.271, respectively). Even after adjusting by PSM, IPTW, and OW, the TyG index remained a risk factor for in-hospital mortality and ICU mortality in patients experiencing CA, which was independent of age, BMI, sex, etc. Correlation analyses revealed that TyG index was negatively correlated with the neurological status of patients post-CA. CONCLUSION: Elevated TyG index is significantly associated with the occurrence of CA and higher mortality risk in patients post-CA. Our findings extend the landscape of TyG index in cardiovascular diseases, which requires further prospective cohort study. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12933-023-01918-0. BioMed Central 2023-07-27 /pmc/articles/PMC10375765/ /pubmed/37501144 http://dx.doi.org/10.1186/s12933-023-01918-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Boshen, Yang
Yuankang, Zhu
Xinjie, Zheng
Taixi, Li
kaifan, Niu
Zhixiang, Wang
Juan, Song
Junli, Duan
Suiji, Li
Xia, Lu
Chengxing, Shen
Triglyceride-glucose index is associated with the occurrence and prognosis of cardiac arrest: a multicenter retrospective observational study
title Triglyceride-glucose index is associated with the occurrence and prognosis of cardiac arrest: a multicenter retrospective observational study
title_full Triglyceride-glucose index is associated with the occurrence and prognosis of cardiac arrest: a multicenter retrospective observational study
title_fullStr Triglyceride-glucose index is associated with the occurrence and prognosis of cardiac arrest: a multicenter retrospective observational study
title_full_unstemmed Triglyceride-glucose index is associated with the occurrence and prognosis of cardiac arrest: a multicenter retrospective observational study
title_short Triglyceride-glucose index is associated with the occurrence and prognosis of cardiac arrest: a multicenter retrospective observational study
title_sort triglyceride-glucose index is associated with the occurrence and prognosis of cardiac arrest: a multicenter retrospective observational study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10375765/
https://www.ncbi.nlm.nih.gov/pubmed/37501144
http://dx.doi.org/10.1186/s12933-023-01918-0
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