The Impact of Triglyceride-Glucose Index On Incident Cardiovascular Events in Patients With Type 2 Diabetes Mellitus

Background: Previous studies reported the prognostic value of the triglyceride-glucose (TyG) index in the course of cardiovascular (CV) diseases. Still, it remains unclear whether baseline and trajectories of TyG index are prospectively associated with incident CV events among patients with type 2 diabetes mellitus (T2DM).Methods: We performed a secondary analysis in patients with long-lasting T2DM from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study. The primary outcome was the first occurrence of adverse CV events including nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes, and the TyG index was measured at 11 visits. Cox proportional hazards regression analysis was used to observe the association between baseline and trajectories of TyG index and adverse CV outcomes.Results: During a median follow-up period of 8.8 years, 1,815 (17.8%) developed at least one primary endpoint event. After adjusting for traditional cardiovascular risk factors, each 1-SD increase in the TyG index was associated with a 19.00% higher risk of adverse CV events, similar in individuals categorized by TyG index quartiles. Four distinct trajectories of TyG indexes were identified- low (16.17%), moderate (40.01%), high (34.60%), and very high (9.30%). Among these, moderate, high, and very high TyG index trajectories had a greater risk of future incident adverse CV events than low TyG index trajectories after multivariate adjustments for traditional risk factors. Particularly, a similar association was noticed in the TyG index and the occurrence of coronary heart disease.Conclusions: The findings of this study suggest that both baseline and trajectories of TyG index have a significant association with the occurrence of adverse CV events in patients with T2DM. (Trial registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000620)