摘要
目的旨在使用竞争风险模型评估(TyG)指数与冠心病患者心血管死亡风险的关系。方法纳入2010年1月—2024年12月本院心血管科诊治的冠心病患者657例。通过RCS分析评估TyG指数与心血管死亡风险的非线性关系,构建多变量竞争风险模型,调整性别、年龄、BMI等多个变量,评估TyG指数与心血管死亡的独立关联。进行亚组分析,评估不同危险分层患者中TyG指数与心血管死亡风险的关系。竞争风险模型的累积发生率曲线分析累计死亡率。结果TyG指数与心血管死亡风险呈显著的非线性关系,较高TyG指数(HR=1.64,95%CI:1.17~2.29,P=0.004)与心血管死亡显著相关。亚组分析显示,TyG指数在男性、年轻人、高BMI和糖尿病患者中的预测效果更为显著。竞争风险模型的累积发生率曲线分析显示,高TyG指数组的心血管死亡发生率显著高于低TyG指数组(P=0.004)。结论TyG指数是冠心病患者心血管死亡的独立预测因子,尤其在特定亚组中具有更强的预测能力。
Objective To evaluate the relationship between the triglyceride-glucose(TyG)index and the risk of cardiovascular death in patients with coronary heart disease(CHD)using a competing risk model.Methods A total of 657 patients with CHD diagnosed and treated in the Department of Cardiology of our hospital from January 2010 to December 2024 were included.The nonlinear relationship between the TyG index and cardiovascular death risk was assessed using restricted cubic spline(RCS)analysis.A multivariable competing risk model was constructed,adjusting for variables such as gender,age,and BMI,to evaluate the independent association between the TyG index and cardiovascular death.Subgroup analysis was conducted to assess the relationship between the TyG index and cardiovascular death risk in patients with different risk stratifications.The cumulative incidence curve of the competing risk model was used to analyze cumulative mortality.Results There was a significant nonlinear relationship between the TyG index and cardiovascular death risk.A higher TyG index(HR=1.64,95%CI:1.17-2.29,P=0.004)was significantly associated with cardiovascular death.Subgroup analysis showed that the TyG index had a more significant predictive effect in males,younger individuals,patients with high BMI,and those with diabetes.The cumulative incidence curve analysis of the competing risk model showed that the incidence of cardiovascular death in the high TyG index group was significantly higher than that in the low TyG index group(P=0.004).Conclusions The TyG index is an independent predictor of cardiovascular death in patients with CHD,especially demonstrating stronger predictive power in specific subgroups.
作者
张建红
刘金涛
刘军
龚艳华
Zhang Jianhong;Liu Jiantao;Liu Jun;Gong Yanhua(People’s Hospital of Xiangdong District,Pingxiang,Jiangxi 337000,China)
出处
《齐齐哈尔医学院学报》
2025年第16期1552-1559,共8页
Journal of Qiqihar Medical University
基金
萍乡市科技计划项目(2024PY201)。
关键词
竞争风险模型
甘油三酯—葡萄糖指数
冠心病
心血管死亡风险
预后
Competing risk model
Triglyceride-glucose index
Coronary heart disease
Cardiovascular death risk
Prognosis
