Impact of Triglyceride-Glucose Index on Cardiovascular Outcomes in Patients Presented With MINOCA

Study Overview
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Brief Summary
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This work was designed to explore the role of the triglyceride-glucose (TyG) index in the prediction of cardiovascular outcomes in Patients Presented with myocardial infarction with nonobstructive coronary arteries.

Detailed Description
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Acute myocardial infarction (AMI) remains the leading causes of high morbidity and mortality worldwide . Recently, a distinct population with myocardial infarction with nonobstructive coronary arteries (MINOCA) has been increasingly recognized because of the widespread use of coronary angiography. MINOCA occurs in 5%-10% of all AMI and they are younger and more often women compared to patients with AMI and obstructive coronary artery disease (CAD). The underlying causes of MINOCA are manifold and may include plaque rupture or erosion, thromboembolism, coronary spasm, spontaneous dissection, microvascular dysfunction and supply/demand mismatch. Some non-ischemic diseases such as myocarditis may also mimic the presentation of MINOCA . Of note, several studies have found that the prognosis of MINOCA is not trivial and patients are still at considerable risks for long-term adverse cardiovascular (CV) events despite the optimal secondary prevention treatments . Thus, it is of necessity and profound implications to find potential residual risk factors and improve prognosis in MINOCA population. Insulin resistance (IR), a critical mechanism of the pathogenesis of diabetes, not only contributes to the development of cardiovascular diseases (CVD), but also significantly correlates with adverse CV outcomes. Additionally, IR often coexists with obesity, hypertension, and dyslipidemia , and all of these are well-known risk factors of CVD. Recently, the triglyceride-glucose (TyG) index derived from fasting triglyceride (TG) and fasting blood glucose (FBG) levels has been proposed as a new and valid surrogate indicator of IR . Till now, many studies have found that the TyG index is positively correlated with metabolic disorders, arterial stiffness , carotid atherogenesis , coronary artery calcification , and subclinical or symptomatic CAD. Moreover, growing evidence has showed that the TyG index is an independent predictor of poor CV outcomes in general population and in different cohorts with CAD, including patients with AMI or acute coronary syndrome (ACS) with or without diabetes

Official Title
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Impact of Triglyceride-Glucose Index on Cardiovascular Outcomes in Patients Presented With Myocardial Infarction With Nonobstructive Coronary Arteries

Conditions
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Major Cardiovascular Events

Intervention / Treatment
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* Diagnostic Test: Triglyceride glucose index TyG


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients; diagnosed with myocardial infarction with nonobstructive coronary arteries (MINOCA) clinical symptoms ECG : ischemic changes with or without ST segment elevation Echocardiograpy : segmental wall motion abnormalities (SWMA) positive cardiac enzymes Coronary angiography: insignificant lesions ,the absence of culprit obstructive coronary artery disease (epicardial coronary artery stenosis ≥50%) Exclusion Criteria: All non confirmed diagnosis of MINOCA cardiac non-ischemic cardiomyopathies non-cardiac pulmonary embolism stroke sepsis ARDS

Ages Eligible for Study
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Maximum Age: 80 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: Triglyceride glucose index TyG|Triglyceride glucose index is an indicator of insulin resistance|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of major adverse cardiovascular events (MACE) | including all-cause death, reinfarction, stroke, re-intervention hospitalization for unstable angina or heart failure) | along one year follow up . | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Triglyceride glucose index Myocardial infarction MINOCA