Association between triglyceride-glucose index and adverse events after carotid artery stenting

Zhang Zheng; Yang Yaoguo; Chen Zhong

doi:10.3969/j.issn.1674-4055.2025.05.16

Abstract：Objective To investigate the predictive value of the Triglyceride-Glucose Index(TyG)for long-term prognosis in elderly patients with carotid artery stenosis after Carotid Artery Stenting(CAS).Methods A total of 304 elderly patients who underwent CAS at Beijing Anzhen Hospital between June 2017 and December 2020 were consecutively enrolled and divided into high and low TyG groups(152 cases each)based on the median TyG value.Patients were followed up for 36 months,with the primary endpoint being adverse events(transient ischemic attack,ischemic stroke,myocardial infarction,and death).Kaplan-Meier analysis was used to analyze survival,Cox regression to evaluate the relationship between TyG and prognosis,and restricted cubic spline analysis to assess their non-linear relationship.Results Kaplan-Meier analysis showed that the incidence of adverse events was significantly higher in the high TyG group compared to the low TyG group(log-rank P＜0.001).Cox regression analysis revealed that after adjusting for confounding factors,the high TyG group had a significantly increased risk of adverse events(HR=3.99,95％CI:1.25-12.74,P=0.02);for each unit increase in TyG,the risk of adverse events increased(HR=3.34,95％CI:1.60-6.97,P=0.001).Restricted cubic spline analysis showed a linear correlation between TyG and adverse event risk(overall P=0.003,non-linear P=0.072).Conclusion Elevated TyG is closely associated with poor long-term prognosis in elderly patients with carotid artery stenosis after CAS.It can serve as an effective stratification tool for assessing long-term risk in elderly CAS patients,providing important reference for individualized treatment decisions and follow-up management in this population.