Prognostic value of the triglyceride-glucose index for major adverse events in acute aortic dissection patients

TL;DR

The triglyceride-glucose (TyG) index is a useful predictor of major adverse events in acute aortic dissection patients, especially in males and smokers.

Contribution

This study identifies the TyG index as an independent predictor of major adverse events in acute aortic dissection patients.

Findings

The TyG index independently predicted major adverse cardiac and cerebrovascular events (MACCEs) in acute aortic dissection patients.

The association was strongest in male patients and smokers.

Other insulin resistance indices did not show significant independent associations with MACCEs.

Abstract

The prognostic value of insulin resistance (IR) indices in patients with acute aortic dissection (AAD) remains unclear. This study investigated the associations between four IR indices and major adverse cardiac and cerebrovascular events (MACCEs) in AAD patients.

We retrospectively analyzed 114 AAD patients from Henan Chest Hospital (December 2017-December 2023). Four IR indices were calculated: triglyceride-glucose (TyG) index, TyG-BMI index, TG/HDL-C ratio, and METS-IR. Multivariable logistic regression models were constructed to evaluate associations with MACCEs. Subgroup analyses were performed in male, hypertensive, diabetic, and smoking patients.

Among 114 patients (mean age 50.67 ± 12.49 years), 55 (48.2%) developed MACCEs. In fully adjusted models, only TyG index independently predicted MACCEs (OR = 2.46, 95% CI: 1.24–4.90, p = 0.010). Subgroup analyses revealed robust associations in male patients (OR = 2.87, 95% CI: 1.24–6.65, p = 0.014) and smokers (OR = 3.13, 95% CI: 1.05–9.31, p = 0.040), but not in hypertensive patients.

An elevated TyG index independently predicts MACCEs in AAD patients, particularly in males and smokers, and may support risk stratification and intensified follow-up in high-risk individuals.

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