Skip to main content

ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Cardiovascular Metabolism
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1517437

Effect of hyperhomocysteinemia on the prognostic value of triglyceride glucose index in patients with acute coronary syndrome

Provisionally accepted

    The final, formatted version of the article will be published soon.

      Background: The prognostic value of triglyceride-glucose (TyG) has been well described in patients with coronary artery disease (CAD). Hyperhomocysteinemia (HHcy) promotes insulin resistance and has also been regarded as a potential risk factor for cardiovascular disease. However, the prognostic value of TyG in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) and the interaction between TyG and HHcy remain unclear. Methods: A total of 1734 ACS patients undergoing PCI were continuously enrolled between June 2016 and November 2017 at Beijing Anzhen Hospital. Patients were categorized into four groups based on HHcy status and the optimal cut-off value of TyG. The primary endpoint was major adverse cardiovascular events (MACE), a composite of all-cause death, nonfatal myocardial infarction, nonfatal stroke, and unplanned repeat revascularization. Results: Over a median follow-up of 927 days, 358 patients (20.6%) experienced MACE. The Kaplan-Meier curves showed significant differences in the cumulative incidence of MACE among prespecified groups (p < 0.001). Multivariable Cox regression analysis revealed that higher TyG was significantly associated with an increased risk of MACE in patients without HHcy (HR 2.36, 95% CI 1.53-3.64, p < 0.001), but not in patients with HHcy (HR 1.31, 95% CI 0.60-2.87, p = 0.503). Restricted cubic splines only demonstrated the prognostic value of TyG in patients without HHcy. A significant interaction was observed for MACE between TyG and HHcy (p for interaction = 0.01). Conclusion: The prognostic value of TyG was modified by HHcy in ACS patients undergoing PCI.Higher TyG was only associated with an increased risk of MACE in ACS patients without HHcy, but not in ACS patients with HHcy.

      Keywords: Hyperhomocysteinemia, Triglyceride glucose index, Acute Coronary Syndrome, Percutaneous Coronary Intervention, Major adverse cardiovascular events

      Received: 26 Oct 2024; Accepted: 30 Dec 2024.

      Copyright: © 2024 . This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

      Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.