Study on the correlation between triglyceride-glucose index and recurrence of atrial fibrillation after catheter ablation in heart failure patients with preserved ejection fraction
Zhao Xiaopai
Shi Jihui
Peng Xiaodong
Ma Changsheng
Abstract：Objective To evaluate the correlation between triglyceride glucose(TyG)index and recur-rence of atrial fibrillation after catheter ablation in heart failure patients with preserved ejection fraction(HFpEF),and to explore a new risk stratification index for atrial fibrillation recurrence.Methods This study is based on a prospective,multicenter Chinese atrial fibrillation registry,which included 413 atrial fibrillation patients who underwent catheter ablation for the first time between August 2011 and December 2020 and met the diagnostic criteria for HFpEF.TyG index was calculated by comparing baseline triglycerides with fasting plasma glucose.The primary outcome was recurrence of atrial fibrillation after a 90d blank-period.Patients were stratified according to the first and third quartiles of TyG index(Q,:8.44,Q3:8.96)and divided into low TyG index group(TyG index＜8.44,137 cases),medium TyG index group(TyG index 8.44-8.96,139 cases),and high TyG index group(TyG index＞8.96,137 cases).Kaplan-Meier survival analysis and multivariate adjusted Cox proportional hazards regression model were used to evaluate the association between TyG index and atrial fibrillation recurrence.Results The average age of 413 patients was(61±11)years old,and 253 cases(61.3％)were male.During a median follow-up of 810 d,256 cases(62.0％)developed recurrent atrial fibrillation events.Each one-standard-deviation increase in the TyG index was associated with a 29％higher risk of atrial fibrillation recurrence[adjusted hazard ratio(HR)=1.29,95％confidence interval(CI):1.07-1.55,P=0.007].Restricted cubic spline model analysis showed that TyG index had a dose-response relationship with the risk of recurrence.Compared with the low TyG index group,patients in the medium and high TyG index group had a 74％(adjusted HR=1.74,95％CI:1.21-2.50,P=0.003)and 106％(adjusted HR=2.06,95％CI:1.36-3.13,P=0.001)increased risk of recurrence,respectively(P for trend=0.001).Conclusions In atrial fibrillation patients with HFpEF,elevated TyG index is associated with a significantly increased risk of atrial fibrillation recurrence after catheter ablation,and there is a dose-response relationship.TyG index,as an economic and practical indicator of insulin resistance,can be used to guide the risk stratification and individualized management of recurrence in this population.
Keywords：Atrial fibrillationHeart failure with preserved ejection fractionCatheter ablationInsulin resistanceRisk factors
Publication Date：2025-07-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 988-992 )