Association Between the Triglyceride-Glucose Index and Acute Myocardial Infarction: A Retrospective Case-Control Study

TL;DR

This study found that a higher triglyceride-glucose index is linked to a greater risk of acute myocardial infarction in hospitalized patients in Mexico.

Contribution

The study provides new evidence on the association between the TyG index and AMI in a Mexican hospitalized population.

Findings

Patients with AMI had significantly higher TyG index values than controls.

The TyG index showed good discriminative performance for AMI with an AUC of 0.84.

An elevated TyG index remained independently associated with AMI after adjusting for multiple risk factors.

Abstract

Introduction: Acute myocardial infarction (AMI) remains a leading cause of morbidity and mortality worldwide. Metabolic abnormalities, particularly insulin resistance, play a central role in the development of atherosclerosis and coronary artery disease. The triglyceride-glucose (TyG) index has emerged as a simple and accessible surrogate marker of insulin resistance and has been associated with cardiovascular risk in diverse populations. However, data regarding its association with AMI in hospitalized populations in Mexico are limited.

Methods: We conducted an observational, analytical, retrospective, non-paired case-control study including adult patients hospitalized in the cardiology department of a secondary care hospital between January 2023 and December 2024. The cases were patients with a confirmed diagnosis of AMI, while controls were patients hospitalized for non-ischemic conditions during the same period. Demographic and clinical variables were collected from electronic medical records. Fasting plasma glucose and triglyceride levels obtained within the first 48 hours of admission were used to calculate the TyG index. Statistical analyses included receiver operating characteristic (ROC) curve analysis and logistic regression models to estimate crude and adjusted odds ratios (ORs).

Results: A total of 288 patients were included, with 144 cases and 144 controls. Patients with AMI had significantly higher TyG index values compared with controls. The TyG index demonstrated good discriminative performance for AMI, with an area under the ROC curve (AUC) of 0.84. A cutoff value of 8.92 was associated with higher odds of AMI. In multivariable logistic regression analysis, an elevated TyG index remained independently associated with AMI after adjustment for age, sex, hypertension, diabetes mellitus, and dyslipidemia.

Conclusion: An elevated TyG index was independently associated with AMI in this retrospective case-control study. These findings support the potential utility of the TyG index as an accessible metabolic marker associated with increased odds of AMI in hospitalized patients.

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