Cardiovasc Diabetol: Comparison of prognostic prediction and stratification of different insulin resistance surrogate indicators for patients with type 2 diabetes after percutaneous coronary intervention

BACKGROUND: Insulin resistance (IR) and the heart is closely related to vascular disease , insulin resistance evaluation difficult and complex
.

Recently, various IR alternative indicators have been proposed and proved to be highly correlated with IR evaluated by the gold standard

Insulin resistance (IR) and heart are closely related to vascular disease heart recently, IR various surrogate markers have been proposed, and proved to be highly related to the gold standard IR evaluation

Results: 2107 patients (60.
02±9.
03 years old, 28.
0% female) finally entered the study
.

During the 24-month follow-up, a total of 187 cases (8.

Figure 1 The incidence of MACCE is calculated based on the median of the respective IR substitutes in the total population
.

MACCE main adverse cardiovascular and cerebrovascular events, TYG triglyceride-glucose, VAI visceral obesity index, CVAI Chinese visceral obesity index, LAP lipid accumulation product, TG/HDL-C triglyceride/high-density lipoprotein cholesterol ratio

Figure 1 The incidence of MACCE is calculated based on the median of the respective IR substitutes in the total population

Figure 2 Based on the median of the total population TYG index (A), VAI (B), CVAI (C), LAP (D) and TG/HDL-C (E), the Kaplan-Meier curve of the survival rate without MACCE was calculated
.

MACCE main adverse cardiovascular and cerebrovascular events, insulin resistance

Figure 2 Based on the median of the total population TYG index (A), VAI (B), CVAI (C), LAP (D) and TG/HDL-C (E), the Kaplan-Meier curve of the survival rate without MACCE was calculated

Table 1 The predictive value of different IR surrogate indicators for MACCE risk in the whole population

Table 1 The predictive value of different IR surrogate indicators for MACCE risk in the whole population

Figure 3 The drug susceptibility analysis is carried out by stratification according to the medication situation at the time of admission
.

Adjusted smoking history, hypertension, T2 DM, previous MI, previous PCI, previous stroke, clinical diagnosis, TC, hs-CRP, EGFR, HbA1c, LVEF, ACEI/ARB at discharge, oral antidiabetic drugs at discharge, and discharge at discharge Insulin, LM disease, three-vessel disease, chronic complete occlusion, grammatical score, complete revascularization and number of stents

Figure 3 The drug susceptibility analysis is carried out by stratification according to the medication situation at the time of admission

Figure 4 Based on the TYG index (A), VAI (B), CVAI (C), LAP (D) and TG/HDL-C (E), three splines are used to limit the risk of MACCE
.

Adjusted smoking history, hypertension, T2 DM, previous MI, previous PCI, previous stroke, clinical diagnosis, TC, hs-CRP, EGFR, HbA1c, LVEF, ACEI/ARB at discharge, oral antidiabetic drugs at discharge, and discharge at discharge Insulin, LM disease, three-vessel disease, chronic complete occlusion, grammatical score, complete revascularization and number of stents

Figure 4 Based on the TYG index (A), VAI (B), CVAI (C), LAP (D) and TG/HDL-C (E), three splines are used to limit the risk of MACCE

Table 2 Diagnostic performance of MACCE IR surrogate indicators in the whole population

Table 2 Diagnostic performance of MACCE IR surrogate indicators in the whole population

Figure 5 ROC curve evaluating the diagnostic performance of each IR surrogate index of MACCE in the total population
.

Triglyceride-glucose, VAI visceral obesity index, CVAI Chinese visceral obesity index, LAP lipid accumulation product, TG/HDL-C triglyceride/high-density lipoprotein cholesterol ratio

Figure 5 ROC curve evaluating the diagnostic performance of each IR surrogate index of MACCE in the total population
.
Triglyceride-glucose, VAI visceral obesity index, CVAI Chinese visceral obesity index, LAP lipid accumulation product, TG/HDL-C triglyceride/high-density lipoprotein cholesterol ratio

Conclusion: The TYG index has the strongest correlation with MACCE risk, and can be used as the most valuable IR surrogate index for predicting and stratifying NSTE-ACS patients (with or without T2 DM) undergoing PCI
.

The TYG index has the strongest correlation with MACCE risk, and can be used as the most valuable IR surrogate index for predicting and stratifying NSTE-ACS patients (with or without T2 DM) undergoing PCI
.

Original source:

Zhao Q, Cheng YJ, Xu YK,et al, Comparison of various insulin resistance surrogates on prognostic prediction and stratification following percutaneous coronary intervention in patients with and without type 2 diabetes mellitus.
Cardiovasc Diabetol 2021 Sep 18;20(1)

Comparison of various insulin resistance surrogates on prognostic prediction and stratification following percutaneous coronary intervention in patients with and without type 2 diabetes mellitus.
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