Introduction and Objective: The triglyceride-glucose index (TyG) is a validated biomarker of insulin resistance. Its power to predict major cardiovascular events (MACE) in patients with established cardiovascular disease is unclear and is addressed in the present study.Methods: We enrolled 1790 consecutive patients, 1481 with angiographically proven CAD and 309 with sonographically proven PAD. Prospectively, MACE were recorded over a mean follow-up period of 10.7±5.0 years.Results: At baseline, the TyG index was significantly higher in patients with T2DM (n=586) than in non-diabetic subjects (9.2±0.7 vs. 8.7±0.5; p<0.001). During follow-up, 916 of our patients suffered MACE. The event rate was significantly higher in patients with T2DM than in non-diabetic subjects (60.2 vs. 47.7%; p<0.001). The TyG index in Cox regression models adjusting for age, sex, hypertension, smoking, body mass index, and LDL-C independently predicted MACE in the total study population (standardized adjusted HR 1.21 [1.12-1.30], p<0.001); HRs in patients without T2DM and in diabetic subjects were 1.08 [0.95-1.25], p=0.272 and 1.16 [1.03-1.31], p=0.013, respectively, with no evidence of an interaction between TyG and T2DM (p=0.093). With T2DM additionally entered into the regression model, TyG in the total study population predicted cardiovascular events independently from the presence of T2DM (HR 1.12 [1.03- 1.23], p=0.008), while T2DM remained independently predictive of MACE after adjustment for TyG (HR 1.42 [1.19-1.67]; p<0.001).Conclusion: From our data we conclude that the TyG index and T2DM are mutually independent predictors of MACE in patients with CAD.
T. Plattner: None. A. Vonbank: None. B. Larcher: None. A. Mader: None. L. Schnetzer: None. M. Neyer: None. J. Vogel: None. P. Elsner: None. A. Leiherer: None. A. Muendlein: None. A. Festa: None. H. Drexel: None. C.H. Saely: None.
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