High Triglyceride-Glucose Index is Associated with Poor Cardiovascular Outcomes in Nondiabetic Patients with ACS with LDL-C below 1.8 mmol/L
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AIM: To evaluate the prognostic value of triglyceride-glucose (TyG) index in nondiabetic patients with acute coronary syndrome (ACS) with low-density lipoprotein cholesterol (LDL-C) below 1.8 mmol/L. METHODS: A total of 1655 nondiabetic patients with ACS with LDL-C below 1.8 mmol/L were included in the analysis. Patients were stratified into two groups. The incidence of acute myocardial infarction (AMI), infarct size in patients with AMI, and major adverse cardiac and cerebral event during a median of 35.6-month follow-up were determined and compared between the two groups. The TyG index was calculated using the following formula: ln [fasting triglycerides (mg/dL)×fasting plasma glucose (mg/dL)/2]. RESULTS: Compared with the TyG index ＜8.33 group, the TyG index ≥ 8.33 group had a significantly higher incidence of AMI (21.2% vs. 15.2%, p=0.014) and larger infarct size in patients with AMI [the peak value of troponin I: 10.4 vs. 4.8 ng/ml, p=0.003; the peak value of Creatine kinase MB: 52.8 vs. 22.0 ng/ml, p=0.006; the peak value of myoglobin: 73.7 vs. 46.0 ng/ml, p=0.038]. Although there was no significant difference in mortality between the two groups, the incidence of revascularization of the TyG index ≥ 8.33 group was significantly higher than that of the TyG index ＜8.33 group (8.9% vs. 5.0%, p=0.035). A multivariable Cox regression revealed that the TyG index was positively associated with revascularization [hazard ratio, 1.67; 95% confidence interval, 1.02-2.75; p=0.043]. CONCLUSIONS: In nondiabetic patients with ACS with LDL-C below 1.8 mmol/L, a high TyG index level was associated with higher incidence of AMI, larger infarct size, and higher incidence of revascularization. A high TyG index level might be a valid predictor of subsequent revascularization.
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A decrease of 1 mmol/L (88.57 mg/dL) in triglycerides has been linked to roughly a 25% reduction in cardiovascular disease risk.
“A decrease of 1 mmol/L (88.57 mg/dL) in triglycerides has been linked to roughly a 25% reduction in cardiovascular disease risk [24, 25]”
From Ketogenic diet-induced changes in adult lipid metabolism: a comprehensive systematic review and meta-regression of randomized controlled trials (2026) · cites this paper as [25]
The Results section compares outcomes by triglyceride-glucose index, and the Discussion reports an association between that index and subsequent revascularization in a specific ACS population. Searches for a 1 mmol/L triglyceride decrease and a 25% cardiovascular-risk reduction found no passage in our copy addressing that quantitative claim. Page numbers were not available. (LLM, conf=0.72)
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Zhao, J., Wei, C., Gong, F., Pang, Z., & Zhao, H. (2026) · BMC Cardiovascular Disorders · doi:10.1186/s12872-026-05799-5
“A decrease of 1 mmol/L (88.57 mg/dL) in triglycerides has been linked to roughly a 25% reduction in cardiovascular disease risk [24, 25], suggesting our findings may correspond to approximately a 6% risk reduction.”
Influential
- Authors
- Zhang, Y., Ding, X., Hua, B., Liu, Q., Gao, H., Chen, H., Zhao, X.-Q., Li, W., & Li, H.
- Affiliations
- Capital Medical University (CN)
- University of Washington (US)
- Venue
- Journal of Atherosclerosis and Thrombosis
- Publisher
- Japan Atherosclerosis Society
- Published
- 2022-02-01
- Volume
- 29
- Issue
- 2
- Pages
- 268-281
- ISSN
- 1340-3478 (ISSN-L)
- 1880-3873
- PMC
- PMC8803555
- OpenAlex
- W3128701330
- Cited by
- 78
- References
- 37
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 18 · 2023: 17 · 2022: 13 · 2021: 9
- FWCI
- 10.64
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Journal of Atherosclerosis and Thrombosis (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (81670315)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- triglyceride-glucose index, acute coronary syndrome, non-diabetic patients, low LDL cholesterol, acute myocardial infarction, infarct size, major adverse cardiac and cerebrovascular events, revascularization, insulin resistance, prognostic factors, cardiovascular outcomes, troponin I, creatine kinase-MB, myoglobin
- MeSH terms
- Aged, Blood Glucose, Female, Hospitalization, Humans, Cholesterol, LDL, Male, Middle Aged, Myocardial Infarction, Predictive Value of Tests, Retrospective Studies, Risk Factors, Triglycerides, Incidence, Survival Rate, Acute Coronary Syndrome, Propensity Score
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