PMID- 35751060 OWN - NLM STAT- MEDLINE DCOM- 20220628 LR - 20220827 IS - 1475-2840 (Electronic) IS - 1475-2840 (Linking) VI - 21 IP - 1 DP - 2022 Jun 24 TI - A synergistic effect of the triglyceride-glucose index and the residual SYNTAX score on the prediction of intermediate-term major adverse cardiac events in patients with type 2 diabetes mellitus undergoing percutaneous coronary intervention. PG - 115 LID - 10.1186/s12933-022-01553-1 [doi] LID - 115 AB - BACKGROUND: The residual SYNTAX score (rSS), a quantitative measure of angiographic completeness of revascularization after percutaneous coronary intervention (PCI), and the triglyceride-glucose index (TyG index), a reliable surrogate marker of insulin resistance, have been regarded as independent predictors of major adverse cardiac events (MACEs) after PCI. Whether a combination of the rSS and the TyG index improves the predictive ability for MACEs in patients with type 2 diabetes mellitus (T2DM) undergoing PCI remains unknown. METHODS: A total of 633 consecutive patients with T2DM who underwent PCI were included in the present analyses. Patients were stratified according to the optimal cutoff point value of the TyG index, or the rSS determined by receiver‑operating characteristic (ROC) curve analysis. The primary endpoint was the composite of MACEs, including all-cause death, nonfatal myocardial infarction, and unplanned repeat revascularization. Cumulative curves were calculated using the Kaplan-Meier method. Multivariate Cox regression was used to identify predictors of MACEs. The predictive value of the TyG index combined with the rSS was estimated by the area under the ROC curve, continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI). RESULTS: During a median follow-up of 18.83 months, 99 patients developed MACEs, more frequently in the patients with a higher TyG index or rSS. Multivariate Cox hazards regression analysis revealed that both the TyG index and rSS were independent predictors of MACEs (hazard ratio 1.8004; 95% CI 1.2603-2.5718; P = 0.0012; 1.0423; 95% CI 1.0088-1.0769; P = 0.0129, respectively). Furthermore, Kaplan-Meier analysis demonstrated that both the TyG index and the rSS were significantly associated with an increased risk of MACEs (log-rank, all P < 0.01). The addition of the rSS and the TyG index to the baseline risk model had an incremental effect on the predictive value for MACE (increase in C-statistic value from 0.660 to 0.732; IDI 0.018; NRI 0.274; all P < 0.01). CONCLUSIONS: The TyG index predicts intermediate-term MACE after PCI in patients with T2DM independent of known cardiovascular risk factors. Adjustment of the rSS by the TyG index further improves the predictive ability for MACEs in patients with T2DM undergoing PCI. CI - (c) 2022. The Author(s). FAU - Xiong, Shiqiang AU - Xiong S AD - Department of Cardiology, the Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610014, Sichuan, China. FAU - Chen, Qiang AU - Chen Q AD - Department of Cardiology, the Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610014, Sichuan, China. FAU - Zhang, Zhen AU - Zhang Z AD - Department of Cardiology, the Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610014, Sichuan, China. FAU - Chen, Yingzhong AU - Chen Y AD - Department of Cardiology, the Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610014, Sichuan, China. FAU - Hou, Jun AU - Hou J AD - Department of Cardiology, the Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610014, Sichuan, China. FAU - Cui, Caiyan AU - Cui C AD - Department of Cardiology, the Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610014, Sichuan, China. FAU - Cheng, Lianchao AU - Cheng L AD - Department of Cardiology, the Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610014, Sichuan, China. FAU - Su, Hong AU - Su H AD - Department of Cardiology, the Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610014, Sichuan, China. FAU - Long, Yu AU - Long Y AD - Department of Cardiology, the Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610014, Sichuan, China. FAU - Yang, Siqi AU - Yang S AD - Department of Cardiology, the Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610014, Sichuan, China. FAU - Qi, Lingyao AU - Qi L AD - Department of Cardiology, the Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610014, Sichuan, China. FAU - Chen, Xu AU - Chen X AD - Department of Cardiology, the Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610014, Sichuan, China. FAU - Liu, Hanxiong AU - Liu H AD - Department of Cardiology, the Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610014, Sichuan, China. lhanx@126.com. FAU - Cai, Lin AU - Cai L AD - Department of Cardiology, the Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610014, Sichuan, China. clin63@hotmail.com. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20220624 PL - England TA - Cardiovasc Diabetol JT - Cardiovascular diabetology JID - 101147637 RN - 0 (Triglycerides) RN - IY9XDZ35W2 (Glucose) SB - IM MH - *Acute Coronary Syndrome/etiology MH - *Diabetes Mellitus, Type 2/complications/diagnosis MH - Disease Progression MH - Glucose MH - Humans MH - *Percutaneous Coronary Intervention/adverse effects MH - Risk Assessment MH - Risk Factors MH - Triglycerides PMC - PMC9233313 OTO - NOTNLM OT - Insulin resistance OT - Major adverse cardiac events OT - Percutaneous coronary intervention OT - Prognosis OT - Residual SYNTAX score OT - Triglyceride-glucose index OT - Type 2 diabetes mellitus COIS- The authors declare that they have no competing interests. EDAT- 2022/06/25 06:00 MHDA- 2022/06/29 06:00 PMCR- 2022/06/24 CRDT- 2022/06/24 23:38 PHST- 2022/05/20 00:00 [received] PHST- 2022/06/11 00:00 [accepted] PHST- 2022/06/24 23:38 [entrez] PHST- 2022/06/25 06:00 [pubmed] PHST- 2022/06/29 06:00 [medline] PHST- 2022/06/24 00:00 [pmc-release] AID - 10.1186/s12933-022-01553-1 [pii] AID - 1553 [pii] AID - 10.1186/s12933-022-01553-1 [doi] PST - epublish SO - Cardiovasc Diabetol. 2022 Jun 24;21(1):115. doi: 10.1186/s12933-022-01553-1.