Jiandong Hao,1 Li Qu,2 Yang Yang,1 Yun Sun,1 Guiping Xu2 

1Graduate School of Xinjiang Medical University, Urumqi, People’s Republic of China; 2Department of Anesthesiology, People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Clinical Research Center for Anesthesia Management, Urumqi, People’s Republic of China

Correspondence: Guiping Xu, Department of Anesthesiology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830001, People’s Republic of China, Email xgpsyl@126.com

Background: The incidence of postoperative adverse cardiovascular events (PACE) in non-cardiac surgery has significantly increased, severely affecting surgical outcomes and patient prognosis. This study investigates the relationship between preoperative triglyceride-glucose (TyG) index and PACE in patients who underwent non-cardiac surgery.
Methods: We conducted a single-center retrospective study, including adult patients (age ≥ 18 years) who underwent non-cardiac surgery. Univariate and multivariate logistic regression analyses assessed the relationship between the TyG index and PACE. Nonlinear correlations were investigated using restricted cubic splines (RCS). Additionally, subgroup analysis was performed to evaluate the relationship between the TyG index and PACE in different subsamples.
Results: 16,066 patients were studied, among which 1505 cases (9.37%) developed PACE, with a median TyG index of 8.61 (8.22, 9.07). Using the lowest quartile of the TyG index as a reference, the fully adjusted (ORs) (95% CIs) for PACE in the second, third, and fourth quartiles of the TyG index were 1.78 (1.49~2.11), 2.16 (1.81~2.59), and 2.30 (1.88~2.83), respectively. After adjusting for all confounding factors, we found that patients with the highest TyG index had a 68% increased risk of PACE (OR 1.68, 95% CI 1.50~1.90). The results of the subgroup analysis were similar to those of the primary analysis. The RCS model suggests a linear positive correlation between the TyG index and the risk of PACE occurrence. (P for overall < 0.001, P for nonlinear = 0.547).
Conclusion: This cohort study indicates that preoperative TyG index is linearly and positively correlated with an increased incidence of PACE in the non-cardiac surgery population. This finding suggests that intensifying the evaluation of the TyG index may provide a more convenient and effective tool for identifying individuals at risk of PACE during non-cardiac surgeries.

Keywords: postoperative adverse cardiovascular events, TyG index, non-cardiac surgery