High Triglyceride-Glucose Index (TyG) is Associated With Adverse Cardiovascular Events in Patients With Type 2 Diabetes Mellitus (T2DM) and Chronic Total Occlusion (CTO) After Percutaneous Coronary Intervention (PCI)

Background: The triglyceride-glucose index (TyG index) is a reliable surrogate marker of insulin resistance, which is associated with cardiovascular disease morbidity and prognosis. However, the predictive value of the TyG index for cardiovascular events in patients with type 2 diabetes mellitus (T2DM) and chronic total occlusion (CTO) after percutaneous coronary intervention (PCI) has not been specifically studied. Method: The study retrospectively enrolled 687 patients with T2DM and CTO after PCI in the final analysis. Patients were divided into three groups according to the TyG index tertiles. The TyG index was calculated as ln [ fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2 ]. The primary observational endpoint was the composite of overall death, non-fatal stroke, non-fatal myocardial infarction (MI), or unplanned revascularization.Results: During a median follow-up of 22.0 months, 159 patients (23.14%) experienced primary endpoint events. Multivariate Cox hazards regression analysis showed that the TyG index was significantly correlated with the primary endpoint [HR 2.827, 95% CI (1.877-4.529), P＜0.001]. Kaplan–Meier curves for the primary endpoint showed a significant difference between the lower and higher TyG index group was mainly driven by the increased incidence of unplanned revascularization (Log-rank P＜0.001).Conclusion: The TyG index may be a remarkable predictor of adverse cardiovascular events, especially unplanned revascularization in patients with T2DM and CTO who are treated by PCI.