Table_1_Triglyceride-glucose index as a potential predictor of major adverse cardiovascular and cerebrovascular events in patients with coronary heart disease complicated with depression.docx

BackgroundTriglyceride-glucose (TyG) index is a surrogate marker of insulin resistance and metabolic abnormalities, which is closely related to the prognosis of a variety of diseases. Patients with both CHD and depression have a higher risk of major adverse cardiovascular and cerebrovascular events (MACCE) and worse outcome. TyG index may be able to predict the adverse prognosis of this special population.
MethodsThe retrospective cohort study involved 596 patients with both CHD and depression between June 2013 and December 2023. The primary outcome endpoint was the occurrence of MACCE, including all-cause death, stroke, MI and emergent coronary revascularization. The receiver operating characteristic (ROC) curve, Cox regression analysis, Kaplan-Meier survival analysis, and restricted cubic spline (RCS) analysis were used to assess the correlation between TyG index and MACCE risk of in patients with CHD complicated with depression.
ResultsWith a median follow-up of 31 (15–62) months, MACCE occurred in 281(47.15%) patients. The area under the ROC curve of TyG index predicting the risk of MACCE was 0.765(0.726–0.804) (P<0.01). Patients in the high TyG index group(69.73%) had a significantly higher risk of developing MACCE than those in the low TyG index group(23.63%) (P<0.01). The multifactorial RCS model showed a nonlinear correlation (nonlinear P<0.01, overall P<0.01), with a critical value of 8.80 for the TyG index to predict the occurrence of MACCE. The TyG index was able to further improve the predictive accuracy of MACCE.
ConclusionsTyG index is a potential predictor of the risk of MACCE in patients with CHD complicated with depression.

【研究背景】甘油三酯-葡萄糖（Triglyceride-glucose, TyG）指数是反映胰岛素抵抗与代谢异常的替代标志物，与多种疾病的预后密切相关。同时罹患冠心病（Coronary Heart Disease, CHD）与抑郁症的患者，发生主要不良心脑血管事件（Major Adverse Cardiovascular and Cerebrovascular Events, MACCE）的风险更高，预后更差。TyG指数或可用于预测这一特殊人群的不良预后。
【研究方法】本研究为回顾性队列研究，纳入2013年6月至2023年12月期间收治的596例同时患有CHD与抑郁症的患者。本研究的主要结局终点为MACCE的发生，涵盖全因死亡、卒中、心肌梗死（Myocardial Infarction, MI）及急诊冠状动脉血运重建术。采用受试者工作特征（Receiver Operating Characteristic, ROC）曲线、Cox回归分析、Kaplan-Meier生存分析以及限制性立方样条（Restricted Cubic Spline, RCS）分析，评估TyG指数与合并抑郁症的CHD患者MACCE风险的相关性。
【研究结果】中位随访时长为31（15~62）个月，共计281例（47.15%）患者发生MACCE。TyG指数预测MACCE风险的ROC曲线下面积为0.765（95%置信区间：0.726~0.804，P<0.01）。高TyG指数组患者的MACCE发生率为69.73%，显著高于低TyG指数组的23.63%（P<0.01）。多因素限制性立方样条模型显示二者存在非线性相关关系（非线性检验P<0.01，整体检验P<0.01），TyG指数预测MACCE发生的临界值为8.80。此外，TyG指数可进一步提升MACCE的预测准确度。
【研究结论】TyG指数是预测合并抑郁症的CHD患者发生MACCE风险的潜在临床标志物。