Triglyceride Glucose Index as a Predictor of 30-Day Readmission and 6 Months Mortality After Hospitalization in Acute Decompensated Heart Failure

  • Arindya Rezeki RS PJNHK
  • Bambang Widyantoro Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia - National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia
  • Vienna Rossimarina Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia - National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia
  • Bambang Dwiputra Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia - National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia
  • Siska Suridanda Danny Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia - National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia
  • Anwar Santoso 1Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia - National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia
  • Renan Sukmawan Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia - National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia.
Keywords: : Acute decompensated heart failure, triglyceride glucose index, 6 months mortality, 30-days readmission.

Abstract

Background: Acute decompensated heart failure (ADHF) is a cardiovascular disease with high mortality and readmission rates. Currently, insulin resistance has been reported to predict prognosis of ADHF patients. Triglyceride glucose index (TyG) has now been proposed as an independent predictor of cardiovascular risk and a simple marker of insulin resistance. However, the association between TyG and 30-days readmission and 6 months mortality after hospitalization remains unclear.

Objective: To investigate TyG as a predictor of 30-day readmission and 6 months mortality after hospitalization in ADHF patients.

Methods: The study was conducted in a retrospective cohort. Data were taken from medical records based on the admission of patients who met the inclusion criteria from January 2018 – November 2021. The clinical outcomes were 30-days readmission and 6 months mortality. The data were analyzed by multivariate analysis and the survival rate of the subjects.

Results: This study included 467 subjects, with 158 subjects have clinical outcomes. The readmission rate is 29% (135 subjects), and 6 month mortality after hospitalization is 5% (23 subjects). Multivariate analysis showed that the factors associated with 30-days readmission were hypertension (p 0.03, HR 1.547, CI 95% 1.044 – 2.291), systolic blood pressure > 140 mmHg on admission (p< 0.001, HR 0.441, CI 95% 0.296 – 0.658), triglyceride ³ 150 mg/dL (p 0.012, HR 1.812, CI 95% 1.139 – 2.881), and TyG index (p <0.001, OR 4.594, CI 95% 2.717 – 7.767). Independent factors for 6 months mortality were only no diuretic medication (p 0.02, HR 6.015, CI 95% 1.975 – 18.320).

Conclusion: Triglyceride glucose index can predict 30-days readmission, but does not associated with  6-months mortality in ADHF patients.

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References

1. Ng KW, Allen ML, Desai A, MacRae D, Pathan N. Cardioprotective effects of insulin: How intensive insulin therapy may benefit cardiac surgery patients. Circulation. 2012;125(5):721–8.
2. Janssen JAMJL. Hyperinsulinemia and its pivotal role in aging, obesity, type 2 diabetes, cardiovascular disease and cancer. Int J Mol Sci. 2021;22(15).
3. Ormazabal V, Nair S, Elfeky O, Aguayo C, Salomon C, Zuñiga FA. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol [Internet]. 2018;17(1):1–14. Available from: https://doi.org/10.1186/s12933-018-0762-4
4. Huang R, Lin Y, Ye X, Zhong X, Xie P, Li M, et al. Triglyceride-glucose index in the development of heart failure and left ventricular dysfunction: Analysis of the ARIC study. Eur J Prev Cardiol. 2022;29(Supplement 1).
5. Gracia E, Singh P, Collins S, Chioncel O, Pang P, Butler J. The Vulnerable Phase of Heart Failure. American Journal of Therapeutics. 2018;25(4):E456- E464. doi:10.1097/MJT.0000000000000794
6. Rao G. Insulin resistance syndrome. Am Fam Physician. 2001;63(6):1159–64.
7. Guerrero-Romero F, Villalobos-Molina R, Jiménez-Flores JR, Simental-Mendia LE, Méndez-Cruz R, Murguía-Romero M, et al. Fasting triglycerides and glucose index as a diagnostic test for insulin resistance in young adults. Arch Med Res. 2016;47(5):382–7.
8. Zhang M, Wang B, Liu Y, Sun X, Luo X, Wang C, et al. Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: The rural chinese cohort study. Cardiovasc Diabetol. 2017;16(1):1–11.
9. Siswanto BB, Radi B, Kalim H, Santoso A, Suryawan R, Erwinanto, et al. Heart failure in NCVC Jakarta and 5 hospitals in Indonesia. CVD Prev Control. 2010;5(1):35–8.
10. Wideqvist M, Cui X, Magnusson C, Schaufelberger M, Fu M. Hospital readmissions of patients with heart failure from real world: timing and associated risk factors. ESC Hear Fail. 2021;8(2):1388–97.
11. Akkineni SSL, Mohammed O, Pathiraj JPK, Devasia T, Chandrababu R, Kunhikatta V. Readmissions and clinical outcomes in heart failure patients: A retrospective study. Clin Epidemiol Glob Heal [Internet]. 2020;8(2):495–500. Available from: https://doi.org/10.1016/j.cegh.2019.11.002
12. Putot S, Hacquin A, Manckoundia P, Putot A. Prognostic impact of systolic blood pressure in acute heart failure with preserved ejection fraction in older patients. ESC Hear Fail. 2021;8(6):5493–500.
13. Faselis C, Arundel C, Patel S, Lam PH, Gottlieb SS, Zile MR, et al. Loop Diuretic Prescription and 30-Day Outcomes in Older Patients With Heart Failure. J Am Coll Cardiol. 2020;76(6):669–79.
14. Faris RF, Flather M, Purcell H, Poole-Wilson PA, Coats AJ. Diuretics for heart failure. Cochrane Database Syst Rev. 2016;2016(4).
15. Toth PP, Philip S, Hull M, Granowitz C. Elevated triglycerides (≥150 mg/dl) and high triglycerides (200–499 mg/dl) are significant predictors of new heart failure diagnosis: A real-world analysis of high-risk statin-treated patients. Vasc Health Risk Manag. 2019;15:533–8.
16. Huang R, Wang Z, Chen J, Bao X, Xu N, Guo S, et al. Prognostic value of triglyceride glucose (TyG) index in patients with acute decompensated heart failure. Cardiovasc Diabetol [Internet]. 2022;21(1):1–14. Available from: https://doi.org/10.1186/s12933-022-01507-7
17. Guo W, Zhao L, Mo F, Peng C, Li L, Xu Y, et al. The prognostic value of the triglyceride glucose index in patients with chronic heart failure and type 2 diabetes: A retrospective cohort study. Diabetes Res Clin Pract [Internet]. 2021;177:108786. Available from: https://doi.org/10.1016/j.diabres.2021.108786
18. Yang S, Du Y, Liu Z, Zhang R, Lin X, Ouyang Y, et al. Triglyceride–Glucose Index and Extracellular Volume Fraction in Patients With Heart Failure. Front Cardiovasc Med. 2021;8(June):1–8.
19. Ashrafian H, Frenneaux MP, Opie LH. Metabolic mechanisms in heart failure. Circulation. 2007;116(4):434–48.
20. Ingelsson E, Sundström J, Ärnlöv J, Zethelius B, Lind L. Insulin resistance and risk of congestive heart failure. J Am Med Assoc. 2005;294(3):334–41.
Published
2024-03-29
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How to Cite
Rezeki, A., Widyantoro, B., Rossimarina, V., Dwiputra, B., Danny, S., Santoso, A., & Sukmawan, R. (2024). Triglyceride Glucose Index as a Predictor of 30-Day Readmission and 6 Months Mortality After Hospitalization in Acute Decompensated Heart Failure. Indonesian Journal of Cardiology, 44(2), 53-60. https://doi.org/10.30701/ijc.1380