TyG指数及TyG指数联合Grace评分对急性心肌梗死患者预后的预测价值

张梦玮; 王宇; 段洋; 陆远; 李承宗; 徐晤; 王志荣

doi:10.13201/j.issn.1001-1439.2021.02.005

TyG指数及TyG指数联合Grace评分对急性心肌梗死患者预后的预测价值

- 徐州医科大学附属医院心内科(江苏徐州, 221000)

详细信息

通讯作者: 王志荣,E-mail:xzzrw@163.com

中图分类号: R542.2

收稿日期: 2020-10-17

TyG index and Grace score of prognostic value in patients with acute myocardial infarction

- Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, China

More Information

Corresponding author: WANG Zhirong, E-mail: xzzrw@163.com

Received Date: 17 October 2020

摘要

摘要: 目的:探讨甘油三酯-葡萄糖指数(TyG指数)与Grace评分单独及联合预测急性心肌梗死(AMI)患者预后的价值。方法:回顾性分析2018年8月—2019年1月于我院确诊的AMI患者临床资料,计算入院TyG指数、Grace评分。临床终点为主要不良心血管事件(MACE)。对比MACE组和非MACE组基线资料。根据TyG指数分组,比较MACE发生率。采用Cox生存分析进行单因素和多因素分析,Spearman相关分析评估TyG指数和Grace风险评分的相关性。采用受试者工作特征曲线(ROC)分析各单因素指标及联合多因素指标预测MACE的效能。结果:TyG指数、Grace评分在MACE组和非MACE组差别有统计学意义(P＜0.001)。高TyG指数组MACE发生率更高。将P＜0.01的指标进行Cox生存分析,结果显示调整混杂因素后TyG指数及Grace评分仍是预测MACE的独立因子(HR 1.038,P＜0.001,95%CI 1.028~1.048;HR 2.467,P＜0.001,95%CI 1.556~3.911)。相关性分析显示TyG指数与Grace评分呈正相关(R=0.286,P＜0.001)。ROC曲线结果显示TyG指数、Grace评分预测MACE的曲线下面积(AUC)分别为0.742、0.829,敏感性分别为86.8%、73.6%,特异性分别是51.9%、78.9%,阈值分别为8.806、167.5。二者联合的预测效能、敏感性和特异性均高于单独预测MACE。Delong检验发现二者联合后均比单独预测MACE更有效(Z=4.437,P＜0.001;Z=2.378,P=0.017)。结论:TyG指数和Grace评分是AMI患者临床预后的独立预测因子,二者呈正相关。TyG联合Grace评分可以提高对AMI预后的预测价值。
- 急性心肌梗死 /
- 风险评估 /
- Grace评分 /
- 甘油三酯-葡萄糖指数
Abstract: Objective: To investigate the value of triglycerides-glucose index(TyG index) and GRACE score in singly or in combination to predict the prognosis of patients with acute myocardial infarction(AMI).Methods: Clinical and laboratory data of AMI patients confirmed in our hospital from August 2018 to January 2019 were retrospectively analyzed, and TyG index and Grace score were calculated. The clinical end point was major adverse cardiovascular events(MACE). Baseline data and laboratory indicators were compared between the MACE group and the non-MACE group. The incidence of MACEs events was compared according to TyG index. Cox survival analysis was used for univariate and multivariate analyses, and Spearman correlation analysis was used to assess the correlation of TyG index and Grace risk score.Results: There were statistically significant differences in TyG index and Grace score between MACE group and non-MACE group. The MACEs event rate was higher in high TyG index group. Cox survival analysis showed that TyG index and Grace score were still independent factors for predicting MACE(HR=1.038, 95%CI: 1.028-1.048, P＜0.001; HR=2.467, 95%CI: 1.556-3.911, P＜0.001). Correlation analysis showed that TyG index was positively correlated with Grace score(R=0.286, P＜0.001). The ROC curve analysis showed that the AUCs of TyG index and Grace score in predicting MACEs events were 0.742 and 0.829 respectively, the sensitivities were 86.8% and 73.6%, the specificities were 51.9% and 78.9%, and the thresholds were 8.806 and 167.5, respectively. The Delong test found that the combination of the TyG index and Grace score was more effective than the single one in prediction of MACEs events.Conclusion: TyG index and Grace score were independent predictors of clinical prognosis in AMI patients. TyG combined with Grace score can improve the predictive value of AMI prognosis.
- acute myocardial infarction /
- risk assessment /
- Grace score /
- TyG index

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