A clinical nomogram based on triglyceride-glucose index for predicting major adverse cardiovascular events in patients with acute coronary syndrome complicated by type 2 diabetes mellitus after PCI
Jin Jingkun
Ding Jiahui
Zhu Yinghua
Qiu Hang
Wang Linsheng
Zhang Xudong
Peng Jingfeng
Li Wen-hua
Abstract：Objective To establish a risk predictive model for forecasting major adverse cardiovascular events(MACE)in patients with acute coronary syndrome(ACS)complicated by type 2 diabetes mellitus(T2DM)within 1 y after percutaneous coronary intervention(PCI),and review validity of the model.Methods The clinical materials were analyzed in patients with ACS complicated by T2DM undergone PCI(n=468)in Affiliated Hospital of Xuzhou Medical University from Jan.2019 to Dec.2021.All patients were divided,according to value of triglyceride-glucose index(TyG),into low-TyG group(TyG≤ 8.77,n=156),mid-TyG group(TyG=8.77～9.47,n=156)and high-TyG group(TyG≥9.47,n=156).The occurrence of MACE was reviewed in 3 groups within 1-y follow-up.The difference in survival was compared by using Kaplan-Meier(K-M)among 3 groups.A nomogram was established based on determined risk factors or clinical features,and its accuracy in predicting MACE was ensured by using concordance index.Results Among 468 patients,there were 148(31.6％)patients with MACE.The results of LASSO regression analysis and multi-factor Cox screen showed that age,smoking,low-density lipoprotein-cholesterol(LDL-C),blood urea,and TyG were independent predictive factors for MACE in patients with ACS complicated by T2DM after PCI.The results of K-M analysis showed that MACE incidence increased with TyG increase in all TyG groups.The effect degree of all above influence factors on outcome variable was calculated and scored,then all scores were added up to get the total score,and risk scores were obtained in training set and validation set.In training set AUC was 0.729(95％CI:0.671～0.788)and in validation set AUC was 0.745(95％CI:0.654～0.836),which indicated that the nomogram had a higher accuracy in MACE prediction.Conclusion When TyG is higher,MACE risk will increase in patients with ACS complicated by T2DM after PCI.The nomogram,established according to determined variables,has some predictive value to MACE occurrence,and is worth clinical application.
Keywords：Acute coronary syndromeTriglyceride-glucose indexPercutaneous coronary interventionType 2 diabetes mellitusMajor adverse cardiovascular eventsNomogramRisk predictive model
Publication Date：2025-02-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 226-231,236 )