Association between triglyceride-glucose index and microvascular obstruction in acute ST-segment elevation myocardial infarction patients after emergency percutaneous coronary intervention
ZHONG Chong-xia
LYU Ji-long
LIU Yi-hai
BAO Xue
KANG Li-na
XU Biao
Abstract：Objective To investigate the predictive value and clinical significance of the triglyceride glucose(TyG)index for microvascular obstruction(MVO)in patients with acute ST-segment elevation myocardial infarction(STEMI)after emergency percutaneous coronary intervention(PCI).Methods 311 patients with first-time STEMI who underwent emergency PCI at Nanjing Drum Tower Hospital affiliated to Nanjing University Medical School from July 2018 to June 2023 were included in the retrospective study.Based on cardiac magnetic resonance(CMR)results at 1 week post-PCI,patients were divided into the MVO(n=198)and the non-MVO(n=113)groups.The baseline characteristics,laboratoryparameters and echocardiographic indexes of the 2 groups were compared.Multicariate Logistic regression was used to identify the independent risk factors for MVO,and the receiver operating characteristic(ROC)curve analysis sed to evaluate the predictive performance of the TyG index.Results The MVO group exhibited significantly higher admission heart rate,white blood cell count,neutrophil count,fasting blood glucose,troponin T(cTnT),creatine kinase-MB(CK-MB)and TyG[8.90(8.41,9.35)vs.8.66(8.25,9.15)]index(all P<0.05),while the systolic blood pressure and left ventricular ejection fraction(LVEF)were lower,but the left ventricular end-diastolic diameter(LVDd)was larger(all P<0.05).Multivariate analysis revealed that the TyG index(OR=2.10,95%CI 1.16-2.93),CK-MB(OR=1.00,95%CI 1.00～1.01),and neutrophil count(OR=1.66,95%CI 1.03-2.73)were the independent risk factors for MVO.ROC analysis showed that the TyG index alone had an area under the curve(AUC)of 0.585(sensitivity 0.626,specificity 0.558)for predicting MVO.When combined with systolic blood pressure,heart rate,LVEF and other parameters,the AUC increased to 0.774(sensitivity 0.756,specificity 0.658).Conclusion Elevated TyG index is independently associated with MVO formation after emergency PCI in STEMI patients.Combining TyG index with traditional clinical parameters significantly improves MVO prediction,offering a novel noninvasive strategy for early risk stratification.
Keywords：Triglyceride glucose indexMicrovascular obstructionAcute ST-segment elevation myocardial infarctionCardiac magnetic resonance
Publication Date：2025-08-20
Online Publishing Date：2025-09-05(First online date of this platform, not the publication date of the document)
Pages：7( 734-740 )