Association between insulin resistance indices and outcomes in patients with heart failure with preserved ejection fraction

Cardiovascular Diabetology, Год журнала: 2025, Номер 24(1)

Опубликована: Янв. 22, 2025

Insulin resistance (IR) plays a pivotal role in the interplay between metabolic disorders and heart failure with preserved ejection fraction (HFpEF). Various non-insulin-based indices emerge as reliable surrogate markers for assessing IR, including triglyceride-glucose (TyG) index, TyG index body mass (TyG-BMI), atherogenic of plasma (AIP), score insulin (METS-IR). However, ability different IR to predict outcome HFpEF patients has not been extensively explored. Patients having were recruited from January 2012 December 2023. The was defined major adverse cardiovascular event (MACE), encompassing all-cause mortality rehospitalization failure. potential linear relationship visualized by restricted cubic spline (RCS) curve. Both univariable multivariable Cox proportional hazards models employed examine association indexes MACE. Furthermore, assess incremental prognostic value we conducted comprehensive analyses using area under curve (AUC), continuous net reclassification (cNRI), integrated discrimination (IDI). A total 8693 met inclusion criteria included final analysis. mean age 70.59 ± 10.6 years, 5045 (58.04%) being male. Kaplan-Meier survival analysis revealed that higher degree four associated risk MACE (all log-rank P < 0.05). When treated variable, showed significant (HR 2.1, 95% CI 1.98–2.23, 0.001 model 1; HR 1.81, 1.73–1.9, 2; 1.68, 1.6–1.76, 3). categorized into quartiles, highest quartile (Q4) significantly 2.48, 2.24–2.76, Similar associations found TyG-BMI, AIP, METS-IR, enhance stratification capability MAGGIC (AUC 0.601 0.666). compared other indicators, exhibited superior abilities predicting Additionally, TyG-BMI U-shaped correlation MACE, indicating both an elevated lower increased risk. All are independently HFpEF. Notably, these predictive accuracy score, widely used assessment tool Among indices, demonstrated discriminatory abilities, providing greatest exhibiting superiority indices. These findings highlight importance particularly management strategies patients. it should be noted our need validated diverse populations ensure their applicability generalizability.

Язык: Английский

Atherogenic index of plasma and coronary artery disease: a systematic review and meta-analysis of observational studies

Cardiovascular Diabetology, Год журнала: 2025, Номер 24(1)

Опубликована: Янв. 22, 2025

Abstract Background Atherogenic index of plasma (AIP), a novel logarithmic that combines fasting triglyceride and high-density lipoprotein cholesterol concentrations, is associated with the burden atherosclerosis. This study aimed to evaluate relationship between AIP coronary artery disease (CAD) risk, severity, prognosis in populations without established CAD. Methods PubMed, Embase, Web Science were systematically searched from inception each database August 13, 2024. Cross-sectional studies, case-control prospective or retrospective cohort studies using multivariate analysis included. Given true effect size may differ across random-effects model for all analyses was applied. Results Fifty-one observational included this study. Patients higher more likely have CAD (odds ratio (OR): 2.79, 95% CI 1.75–4.45, P < 0.00001). Furthermore, these patients calcification (OR: 2.28, 1.74–3.00, 0.00001), multivessel 2.04, 1.50–2.77, an increased risk plaque progression 1.49, 1.17–1.91, = 0.001). In CAD, levels Major adverse cardiovascular events (MACE) (hazard (HR): 1.28, 1.22–1.35, Interestingly, finding consistent presenting acute syndrome (HR: 1.59, 1.33–1.89, 0.00001) chronic stable 1.65, 1.15–2.37, 0.007). Conclusions meta-analysis demonstrates elevated strongly greater poorer However, are needed predictive performance determine optimal cut-off different populations. Graphical abstract

Язык: Английский