Triglyceride‐glucose index trajectories predict adverse cardiovascular outcomes in elderly heart failure patients with Diabetes: A retrospective cohort study
Abstract Objective Evaluating the change trajectories of triglyceride‐glucose (TyG) index calculated after multiple tests in elderly heart failure (HF) patients may have clinical implications for predicting long‐term adverse cardiovascular events (MACEs). Methods This retrospective study included 11...
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Wiley
2024-12-01
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| Series: | Aging Medicine |
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| Online Access: | https://doi.org/10.1002/agm2.12374 |
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| author | Hong Liu Jian Wang Zhi Luo Ding Jia Shixing Feng Zhufang Yang Zeyu Wang |
| author_facet | Hong Liu Jian Wang Zhi Luo Ding Jia Shixing Feng Zhufang Yang Zeyu Wang |
| author_sort | Hong Liu |
| collection | DOAJ |
| description | Abstract Objective Evaluating the change trajectories of triglyceride‐glucose (TyG) index calculated after multiple tests in elderly heart failure (HF) patients may have clinical implications for predicting long‐term adverse cardiovascular events (MACEs). Methods This retrospective study included 1184 elderly HF (LVEF ≥50%) patients with diabetes admitted to our center between January 2015 and January 2020. Based on the multiple TyG levels detected during the exposure period with annual measurements, three distinct TyG trajectories were determined using latent mixture modeling: low‐stable group (TyG index <8.26, n = 367), medium‐stable group (TyG index 8.26–9.06, n = 613), and high‐increasing group (TyG index >9.06, n = 204). The primary endpoint was the composite outcome of MACEs. Results There were significant increases in the prevalence of several cardiovascular risk factors and conditions, such as male gender, BMI, current smoker, hyperlipidemia, atrial fibrillation, old myocardial infarction, fasting glucose, triglycerides, and uric acid levels, from the Low‐Stable Group to the High‐Increasing Group (all P < 0.05). During a median follow‐up of 29 months (range, 18–46 months), 181 MACEs occurred. Kaplan–Meier analyses curve showed a significantly increased risk of MACEs in the medium‐stable and high‐increasing groups compared to the low‐stable group (HR = 2.528, 95%CI: 1.665–3.838; HR = 2.706, 95%CI: 1.722–4.255, respectively). Furthermore, the rates of heart failure‐related hospitalizations, nonfatal myocardial infarctions and non‐fatal stroke were significantly increased in the medium‐stable and high‐increasing groups. Multivariable Cox regression analyses revealed that age (HR = 1.728), current smoker (HR = 1.385), old myocardial infarction (HR = 1.593), chronic renal disease (HR = 1.682), HbA1c (HR = 1.816), NT‐proBNP (HR = 2.471), TyG trajectory (HR = 2.112) and SGLT2 inhibitors (HR = 0.841) were independently associated with the occurrence of MACEs during follow‐up (P < 0.05). Conclusions The TyG trajectory is strongly associated with the risk of MACEs during follow‐up in elderly patients with T2DM, suggesting that TyG trajectories may further optimize risk stratification model of cardiovascular events. |
| format | Article |
| id | doaj-art-dcbd843a32fd44588c2a185b1d4926a0 |
| institution | Kabale University |
| issn | 2475-0360 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Aging Medicine |
| spelling | doaj-art-dcbd843a32fd44588c2a185b1d4926a02025-01-04T08:39:02ZengWileyAging Medicine2475-03602024-12-017671772610.1002/agm2.12374Triglyceride‐glucose index trajectories predict adverse cardiovascular outcomes in elderly heart failure patients with Diabetes: A retrospective cohort studyHong Liu0Jian Wang1Zhi Luo2Ding Jia3Shixing Feng4Zhufang Yang5Zeyu Wang6Department of Cardiology Beijing Geriatric Hospital Beijing ChinaDepartment of Cardiology Beijing Geriatric Hospital Beijing ChinaDepartment of Cardiology Beijing Geriatric Hospital Beijing ChinaDepartment of Cardiology Beijing Geriatric Hospital Beijing ChinaDepartment of Cardiology Beijing Geriatric Hospital Beijing ChinaDepartment of Cardiology Beijing Geriatric Hospital Beijing ChinaDepartment of Cardiology Beijing Geriatric Hospital Beijing ChinaAbstract Objective Evaluating the change trajectories of triglyceride‐glucose (TyG) index calculated after multiple tests in elderly heart failure (HF) patients may have clinical implications for predicting long‐term adverse cardiovascular events (MACEs). Methods This retrospective study included 1184 elderly HF (LVEF ≥50%) patients with diabetes admitted to our center between January 2015 and January 2020. Based on the multiple TyG levels detected during the exposure period with annual measurements, three distinct TyG trajectories were determined using latent mixture modeling: low‐stable group (TyG index <8.26, n = 367), medium‐stable group (TyG index 8.26–9.06, n = 613), and high‐increasing group (TyG index >9.06, n = 204). The primary endpoint was the composite outcome of MACEs. Results There were significant increases in the prevalence of several cardiovascular risk factors and conditions, such as male gender, BMI, current smoker, hyperlipidemia, atrial fibrillation, old myocardial infarction, fasting glucose, triglycerides, and uric acid levels, from the Low‐Stable Group to the High‐Increasing Group (all P < 0.05). During a median follow‐up of 29 months (range, 18–46 months), 181 MACEs occurred. Kaplan–Meier analyses curve showed a significantly increased risk of MACEs in the medium‐stable and high‐increasing groups compared to the low‐stable group (HR = 2.528, 95%CI: 1.665–3.838; HR = 2.706, 95%CI: 1.722–4.255, respectively). Furthermore, the rates of heart failure‐related hospitalizations, nonfatal myocardial infarctions and non‐fatal stroke were significantly increased in the medium‐stable and high‐increasing groups. Multivariable Cox regression analyses revealed that age (HR = 1.728), current smoker (HR = 1.385), old myocardial infarction (HR = 1.593), chronic renal disease (HR = 1.682), HbA1c (HR = 1.816), NT‐proBNP (HR = 2.471), TyG trajectory (HR = 2.112) and SGLT2 inhibitors (HR = 0.841) were independently associated with the occurrence of MACEs during follow‐up (P < 0.05). Conclusions The TyG trajectory is strongly associated with the risk of MACEs during follow‐up in elderly patients with T2DM, suggesting that TyG trajectories may further optimize risk stratification model of cardiovascular events.https://doi.org/10.1002/agm2.12374adverse cardiovascular eventsagingheart failuretrajectoriestriglyceride‐glucose index |
| spellingShingle | Hong Liu Jian Wang Zhi Luo Ding Jia Shixing Feng Zhufang Yang Zeyu Wang Triglyceride‐glucose index trajectories predict adverse cardiovascular outcomes in elderly heart failure patients with Diabetes: A retrospective cohort study Aging Medicine adverse cardiovascular events aging heart failure trajectories triglyceride‐glucose index |
| title | Triglyceride‐glucose index trajectories predict adverse cardiovascular outcomes in elderly heart failure patients with Diabetes: A retrospective cohort study |
| title_full | Triglyceride‐glucose index trajectories predict adverse cardiovascular outcomes in elderly heart failure patients with Diabetes: A retrospective cohort study |
| title_fullStr | Triglyceride‐glucose index trajectories predict adverse cardiovascular outcomes in elderly heart failure patients with Diabetes: A retrospective cohort study |
| title_full_unstemmed | Triglyceride‐glucose index trajectories predict adverse cardiovascular outcomes in elderly heart failure patients with Diabetes: A retrospective cohort study |
| title_short | Triglyceride‐glucose index trajectories predict adverse cardiovascular outcomes in elderly heart failure patients with Diabetes: A retrospective cohort study |
| title_sort | triglyceride glucose index trajectories predict adverse cardiovascular outcomes in elderly heart failure patients with diabetes a retrospective cohort study |
| topic | adverse cardiovascular events aging heart failure trajectories triglyceride‐glucose index |
| url | https://doi.org/10.1002/agm2.12374 |
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