Observational studyCardiovascular diabetology2024
Insulin resistance, coronary artery lesion complexity and adverse cardiovascular outcomes in patients with acute coronary syndrome.
Observational study in Cardiovascular diabetology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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The trial behind it
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Association of the Triglyceride-Glucose Index with Major Adverse Cardiovascular Events in Patients with Acute Coronary Syndromes: A Systematic Review and Meta-Analysis.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Does diabetes status modify the association between the triglyceride-glucose index and major adverse cardiovascular events in patients with coronary heart disease? A systematic review and meta-analysis of longitudinal cohort studies.Cardiovascular diabetology · 2025Pooled it
- Association of the Triglyceride-Glucose Index with Premature Myocardial Infarction in a Propensity Score-Matched Non-Diabetic Population.Diagnostics (Basel, Switzerland) · 2026Article
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- Synergistic effects of insulin resistance and revascularization completeness on prognosis in patients with coronary artery calcification.Cardiovascular diabetology · 2026Observational
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- Article
- The cholesterol, high-density lipoprotein, and glucose (CHG) index as a novel metabolic marker for predicting adverse outcomes in myocardial infarction survivors: insights from two large prospective cohorts.Cardiovascular diabetology · 2026Article
- The role of inflammation and coronary artery lesion severity in patients undergoing percutaneous coronary intervention: a retrospective cohort study.BMC cardiovascular disorders · 2026Article
- E-selectin, but not CRP, partially mediates the association between metabolic indices and insulin resistance in older adults: a mediation analysis.Asian biomedicine : research, reviews and news · 2026Article
- A Novel Risk Score Based on Lipid-Related Biomarkers for Acute Coronary Syndromes: A Multicenter Machine Learning Study.Reviews in cardiovascular medicine · 2026Article
- Association Between Hemoglobin Glycation Index and Delirium Risk in Sepsis Patients in the Intensive Care UnitBalkan medical journal · 2026Article
- C-reactive protein-triglyceride-glucose index and diabetes status for risk stratification in stage 4 cardiovascular-kidney-metabolic syndrome with acute decompensated heart failure: a retrospective cohort study.Frontiers in nutrition · 2026Article
- Association between the C-reactive protein-triglyceride-glucose index and major adverse cardiovascular events in patients undergoing percutaneous coronary intervention.Frontiers in medicine · 2026Article
- Association between insulin resistance and sudomotor dysfunction in adults with type 1 diabetes.Endocrine connections · 2025Article
- Comparative analysis of insulin resistance indicators in predicting reversion from prediabetes to normoglycemia.Diabetology & metabolic syndrome · 2025Article
- Non-linear relationship between the triglyceride glucose-a body shape index and stroke risk: a prospective cohort study from the China health and retirement longitudinal study.Diabetology & metabolic syndrome · 2025Article
- The Synergistic Risk of Insulin Resistance and Renal Dysfunction in Acute Coronary Syndrome Patients After Percutaneous Coronary Intervention.Journal of cardiovascular development and disease · 2025Article
- Triglyceride glucose index in patients with acute coronary syndrome undergoing percutaneous coronary intervention predicts cardiovascular events: a cohort study.Cardiovascular diabetology · 2025Observational
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Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundInsulin resistance (IR) is linked to both the complexity of coronary artery lesions and the prognosis of acute coronary syndrome (ACS). However, the precise extent of this correlation and its impact on adverse cardiovascular outcomes in ACS patients remain unclear. Therefore, this study aims to investigate the intricate relationship between IR, coronary artery lesion complexity, and the prognosis of ACS through a cohort design analysis.
methodA total of 986 patients with ACS who underwent percutaneous coronary intervention (PCI) were included in this analysis. IR was assessed using the triglyceride-glucose (TyG) index, while coronary artery lesion complexity was evaluated using the SYNTAX score. Pearson's correlation coefficients were utilized to analyze the correlations between variables. The association of the TyG index and SYNTAX score with major adverse cardiovascular events (MACEs) in ACS was investigated using the Kaplan-Meier method, restricted cubic splines (RCS), and adjusted Cox regression. Additionally, a novel 2-stage regression method for survival data was employed in mediation analysis to explore the mediating impact of the SYNTAX score on the association between the TyG index and adverse cardiovascular outcomes, including MACEs and unplanned revascularization.
resultsDuring a median follow-up of 30.72 months, 167 cases of MACEs were documented, including 66 all-cause deaths (6.69%), 26 nonfatal myocardial infarctions (MIs) (2.64%), and 99 unplanned revascularizations (10.04%). The incidence of MACEs, all-cause death, and unplanned revascularization increased with elevated TyG index and SYNTAX score. Both the TyG index (non-linear, P = 0.119) and SYNTAX score (non-linear, P = 0.004) displayed a positive dose-response relationship with MACEs, as illustrated by the RCS curve. Following adjustment for multiple factors, both the TyG index and SYNTAX score emerged as significant predictors of MACEs across the total population and various subgroups. Mediation analysis indicated that the SYNTAX score mediated 25.03%, 18.00%, 14.93%, and 11.53% of the correlation between the TyG index and MACEs in different adjusted models, respectively. Similar mediating effects were observed when endpoint was defined as unplanned revascularization.
conclusionElevated baseline TyG index and SYNTAX score were associated with a higher risk of MACEs in ACS. Furthermore, the SYNTAX score partially mediated the relationship between the TyG index and adverse cardiovascular outcomes.
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