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Associations between an insulin resistance index and subclinical atherosclerosis progression in a coronary population
Session:
SESSÃO DE COMUNICAÇÕES ORAIS 07 - PRÉMIO FERRER MELHOR COMUNICAÇÃO ORAL EM PREVENÇÃO SECUNDÁRIA
Speaker:
Gonçalo Bettencourt Abreu
Congress:
CPC 2025
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.3 Secondary Prevention
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Gonçalo Bettencourt Abreu; Isabel Mendonça; Débora Sá; Francisco Sousa; Matilde Ferreira; Eva Henriques; Sofia Borges; António Drummond; Ana Célia Sousa; Roberto Palma Dos Reis
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:#0e101a">Background</span></strong><span style="color:#0e101a">: Insulin resistance (IR), with its myriad proatherogenic effects, is a relevant risk factor for atherosclerosis. The triglyceride-glucose index (TyG) is a marker of IR and subclinical atherosclerosis. Its potential in coronary artery disease (CAD) prognostic assessment has little been explored, but the evidence suggests significant potential.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:#0e101a">Aim:</span></strong><span style="color:#0e101a"> Investigate the association between an IR index, </span><span style="color:#0e101a">triglyceride-glucose index (TyG), and cardiovascular and non-vascular events in a coronary population.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:#0e101a">Methods</span></strong><span style="color:#0e101a">: We included 1719 coronary patients with at least 70% stenosis in one or more main coronary arteries or their primary branches on coronary angiography. These patients were in stabilized phase </span><span style="color:#0e101a">after appropriate interventional approach (angioplasty with coronary stenting), coronary artery bypass graft (CABG) surgery and suitable medical therapy despite some residual Ischemia. </span><span style="color:#0e101a">Total events, including cardiovascular (CV) events, and non CV mortality were registered </span><span style="color:#0e101a">throughout an extended follow-up </span><span style="color:#0e101a">(</span>average 7.0±5.7 years)<span style="color:#0e101a">. TyG was calculated through the formula ln[Triglyceride mg/dl*fast blood glucose (FBG) mg/dl)/2], which was subsequently stratified into terciles. All analyses were performed using the TyG 3<sup>rd</sup> tercile relatively to 1<sup>st</sup>. Bivariate analysis evaluated its association with other markers: pulse wave velocity (PWV), fibrinogen, C reactive protein (CRP), and clinical variables. A multivariate Cox regression analysis assessed the variables associated with total events.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:#0e101a">Results:</span></strong><span style="color:#0e101a"> TyG was associated with PWV (p<0.0001), CRP (p<0.0001), kidney failure (p<0.0001), peripheral vascular disease (p<0.0001), stroke (p<0.0001), CV events (p=0.001), and total events (p<0.0001) in bivariate analysis. After Cox analysis adjusted to age, gender, diabetes, dyslipidemia, hypertension, smoking, alcohol>300/week, obesity, sedentary lifestyle, CRP, fibrinogen, lipoprotein(a), PWV and TyG index, this marker remained as a significant and independent risk factor for total events (HR-1.19; p=0.020), together with age (p=0.001), sedentary lifestyle (p<0.0001) and high CRP (p<0.0001).</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="color:#0e101a">Conclusion</span></strong><span style="color:#0e101a">: TyG index, cheap and easy to determine, was strongly associated with residual inflammation, atherosclerosis progression, CV events and mortality. Early identification of patients with higher TyG indices before deleterious events occur may be valuable for predicting disease progression in high-risk patients, allowing timely adoption of appropriate preventive measures.</span></span></span></p>
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