Qingqing Zhang,1,2,* Yanling Xu,3,* Si Sun,1,* Xiangwei Ding,4 Guoyu Wang,1,4 Suyun Jiang,1 Jing Zheng,1 Peng Gao,1 Jie Lin,4 Yucheng Wu4 

1Department of Pan-Vascular Management Center, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, People’s Republic of China; 2Department of Endocrinology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, People’s Republic of China; 3Department of General Practice, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 4Department of Cardiology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Jie Lin; Yucheng Wu, Department of Cardiology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, 366 Taihu Road, Taizhou, Jiangsu, 225300, People’s Republic of China, Email tzcgc7909@163.com; 2567181759@qq.com

Background: The relationship between a low TyG index and mortality risk in Acute Decompensated Heart Failure (ADHF) also remains unclear. This study aimed to investigate the association between a low TyG index and 1-year mortality in ADHF patients without diabetes.
Methods: A total of 652 hospitalized patients with ADHF without diabetes from January, 2020 to May, 2023 were included in this retrospective study. The primary outcomes were all-cause mortality and cardiovascular mortality within one year. The association between the TyG index and both all-cause and cardiovascular mortality was investigated using restricted cubic splines and multivariate Cox proportional hazards models.
Results: The study enrolled a total of 652 patients with acute decompensated heart failure (ADHF) who were free from diabetes (70.6% male). Within one year, there were 72 deaths from all causes and 40 deaths from cardiovascular disease. In multivariate Cox proportional hazards models, a significant negative relationship was observed between the TyG index and both all-cause mortality (hazard ratio [HR] = 0.371, 95% confidence interval [CI] 0.201– 0.685) and cardiovascular mortality (HR = 0.336, 95% CI 0.151– 0.744). The restricted cubic spline analysis illustrated a decrease in the risk of all-cause and cardiovascular mortality as the TyG index increased. Hypertension, BMI, age, atrial fibrillation significantly interacted with the TyG index in relation to all-cause mortality, while hypertension specifically interacted with the TyG index regarding cardiovascular mortality.
Conclusion: In patients diagnosed with ADHF without diabetes, a lower TyG index is strongly related to a higher risk of 1-year all-cause and cardiovascular mortality. Therefore, it is important to pay close attention to low TyG index levels and implement appropriate measures in clinical practice.

Keywords: acute decompensated heart failure, all-cause death, cardiovascular death, retrospective study, triglyceride glucose product index