Triglyceride-glucose index and triglyceride to high-density lipoprotein cholesterol ratio predict the prognosis in patients with type B aortic dissection receiving thoracic endovascular aortic repair

Kaiwen Zhao; Jinzhu Niu; Hongqiao Zhu; Rong Zhao; Yudong Sun; Shuangshuang Li; Zaiping Jing; Jian Zhou

doi:10.21037/jtd-23-1411

Triglyceride-glucose index and triglyceride to high-density lipoprotein cholesterol ratio predict the prognosis in patients with type B aortic dissection receiving thoracic endovascular aortic repair

J Thorac Dis. 2024 Mar 29;16(3):1971-1983. doi: 10.21037/jtd-23-1411. Epub 2024 Mar 27.

Authors

Kaiwen Zhao^#¹, Jinzhu Niu^#¹, Hongqiao Zhu^#¹, Rong Zhao¹, Yudong Sun², Shuangshuang Li¹, Zaiping Jing^#¹, Jian Zhou^#^{1

3}

Affiliations

¹ Department of Vascular Surgery, The First Affiliated Hospital of the Navy Medical University, Shanghai, China.
² Depaertment of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
³ Shanghai Key Laboratory of Vascular Lesions Regulation and Remodeling, Shanghai, China.

^# Contributed equally.

Abstract

Background: The triglyceride-glucose (TyG) index and triglyceride to high-density lipoprotein cholesterol (TG/HDL-c) ratio are both reliable surrogate indicator of insulin resistance and have been shown to be valuable in predicting various cardiovascular diseases. However, few studies have explored its association with the prognosis of type B aortic dissection (TBAD) patients receiving thoracic endovascular aortic repair (TEVAR).

Methods: A total of 1,425 consecutive patients who underwent TEVAR were included. Data from 935 patients were analyzed in the study. The endpoint was defined as 30-day and 1-year aortic-related adverse events (ARAEs), all-cause mortality, and major adverse cardiovascular and cerebrovascular events (MACCEs).

Results: There were 935 patients included during a mean follow-up time of 2.8 years. After adjusting for multiple confounding factors, continuous TG/HDL-c [hazard ratio (HR) =1.07; 95% confidence interval (CI): 1.00-1.15; P=0.041] was independently associated with 1-year all-cause mortality. Both a high (Quintile 5: TG/HDL-c ratio ≥4.11) (HR =4.84; 95% CI: 1.55-15.13; P=0.007) and low TG/HDL-c ratio (Quintile 1: TG/HDL-c ratio <1.44) (HR =4.67; 95% CI: 1.46-14.94; P=0.001) were still independent risk factors for 1-year all-cause mortality.

Conclusions: Elevated baseline TG/HDL-c ratio and TG/HDL-c ≥4.11 were significantly related to a higher risk of 1-year all-cause mortality among TBAD patients undergoing TEVAR. At the same time, the low TG/HDL-c ratio was also independently associated with 1-year all-cause mortality. Special attention should be paid to TBAD patients with a higher or an overly low TG/HDL-c ratio.

Keywords: Type B aortic dissection (TBAD); insulin resistance (IR); thoracic endovascular aortic repair (TEVAR); triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-c ratio); triglyceride-glucose index (TyG index).