TYG Index as a Novel Predictor of Clinical Outcomes in Advanced Chronic Heart Failure with Renal Dysfunction Patients

Figures & data

Figure 1 The flow chart of participants inclusion.

Table 1 Clinical and Laboratory Characteristics According to the TyG (MACEs)

Variables	Low TyG (n=318)	High TyG (n=399)	χ^2/t/z	P
Age>60, n (%)	154 (48.43)	206 (51.63)	χ²=0.73	0.394
Male, n (%)	217 (68.24)	219 (54.89)	χ²=13.24	<0.001
Coronary heart disease, n (%)	130 (40.88)	210 (52.63)	χ²=9.80	0.002
Hypertension, n (%)	223 (70.13)	273 (68.42)	χ²=0.24	0.623
Arrhythmia, n (%)	101 (31.76)	121 (30.33)	χ²=0.17	0.680
Diabetes, n (%)	86 (27.04)	162 (40.60)	χ²=14.38	<0.001
Hyperlipidemia, n (%)	1 (0.31)	15 (3.76)	χ²=9.63	0.002
Cerebrovascular disease, n (%)	53 (16.67)	76 (19.05)	χ²=0.68	0.410
Chronic kidney disease, n (%)	219 (68.87)	244 (61.15)	χ²=4.60	0.032
Peripheral vascular disease, n (%)	42 (13.21)	65 (16.29)	χ²=1.32	0.250
Thyroid disease, n (%)	71 (22.33)	74 (18.55)	χ²=1.57	0.211
Chronic lung disease, n (%)	65 (20.44)	94 (23.56)	χ²=1.00	0.318
Smoking history, n (%)	87 (27.36)	111 (27.82)	χ²=0.02	0.891
Drinking history, n (%)	60 (18.87)	67 (16.79)	χ²=0.52	0.469
White blood cell, 10^9/L	6.21 (5.10, 8.25)	7.01 (5.59, 9.47)	Z=−3.98	<0.001
Red blood cell, 10^9/L	3.42 (2.81, 4.11)	3.53 (2.95, 4.22)	Z=−1.88	0.060
Hemoglobin, g/L	104.60 (85.00, 126.00)	107.30 (86.25, 128.50)	Z=−1.33	0.184
Platelet, 10^9/L	176.00 (136.00, 225.00)	190.00 (140.00, 251.00)	Z=−2.57	0.010
Neutrophil, 10^9/L	4.42 (3.36, 6.03)	5.18 (3.87, 7.41)	Z=−4.38	<0.001
Lymphocyte, 10^9/L	1.04 (0.74, 1.45)	1.06 (0.76, 1.50)	Z=−0.66	0.510
Eosinophil, 10^9/L	0.10 (0.03, 0.19)	0.08 (0.03, 0.16)	Z=−1.53	0.125
Basophil, 10^9/L	0.03 (0.01, 0.04)	0.02 (0.01, 0.04)	Z=−1.05	0.295
Thrombin time, s	11.20 (10.40, 12.20)	11.00 (10.30, 12.45)	Z=−0.96	0.338
Fibrinogen, g/L	3.36 (2.83, 4.11)	3.69 (2.89, 4.52)	Z=−2.78	0.005
Blood urea nitrogen, mmol/L	17.72 (9.30, 26.15)	15.40 (8.50, 24.18)	Z=−1.83	0.068
Creatinine, μmol/L	392.35 (99.25, 789.08)	259.00 (100.00, 607.60)	Z=−2.48	0.013
Uric acid, mmol/L	385.00 (286.25, 476.25)	409.00 (305.50, 512.00)	Z=−1.97	0.049
eGFR, mL/(min/1.73 m^2)	11.76 (5.82, 60.52)	19.82 (6.61, 60.53)	Z=−2.17	0.030
Albumin, g/L	36.85 (33.12, 40.70)	35.90 (31.90, 40.30)	Z=−2.28	0.023
Globulin, g/L	27.70 (23.10, 32.98)	29.60 (25.20, 33.25)	Z=−2.84	0.004
Total bilirubin, μmol/L	8.20 (5.38, 14.18)	8.40 (5.55, 14.65)	Z=−0.65	0.516
Total cholesterol, mmol/L	3.46 (2.85, 4.15)	3.89 (3.21, 4.75)	Z=−5.89	<0.001
Triglyceride, mmol/L	0.76 (0.59, 1.00)	1.73 (1.25, 2.30)	Z=−19.23	<0.001
HDL-C, mmol/L	1.03 (0.84, 1.24)	0.90 (0.73, 1.17)	Z=−4.60	<0.001
LDL-C, mmol/L	1.98 (1.51, 2.55)	2.26 (1.64, 2.91)	Z=−3.54	<0.001
Troponin, ng/mL	0.03 (0.01, 0.09)	0.05 (0.03, 0.14)	Z=−4.12	<0.001
CK-MB ng/mL	13.00 (8.00, 18.00)	13.00 (7.00, 22.00)	Z=−1.13	0.260
C-reactive protein, mg/L	8.85 (2.78, 27.49)	11.08 (4.16, 33.30)	Z=−2.29	0.022
Blood glucose, mmol/L	4.60 (3.97, 5.64)	6.88 (5.30, 9.11)	Z=−13.31	<0.001
Glycosylated hemoglobin, %	5.70 (5.20, 6.10)	6.00 (5.50, 7.18)	Z=−6.89	<0.001
Aspirin, n (%)	99 (31.13)	138 (34.59)	χ²=0.95	0.329
Ticagrelor, n (%)	21 (6.60)	40 (10.03)	χ²=2.66	0.103
Clopidogrel, n (%)	43 (13.52)	80 (20.05)	χ²=5.31	0.021
ARNI, n (%)	92 (28.93)	91 (22.81)	χ²=3.49	0.062
ACEI, n (%)	147 (46.23)	168 (42.11)	χ²=1.22	0.269
Beta-blocker, n (%)	163 (51.26)	237 (59.40)	χ²=4.75	0.029
Diuretics, n (%)	121 (38.05)	181 (45.36)	χ²=3.88	0.049
Statins, n (%)	130 (40.88)	195 (48.87)	χ²=4.56	0.033
Digoxin, n (%)	37 (11.64)	45 (11.28)	χ²=0.02	0.881
CCB, n (%)	142 (44.65)	150 (37.59)	χ²=3.65	0.056

Notes: Continuous variables are expressed using the median and interquartile range (25%, 75%). Categorical variables are presented as case numbers (percentages).

Abbreviations: eGFR, estimated glomerular filtration rate; HDL-C, high density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol; CK-MB, creatine kinase-myoglobin binding; ARNI, angiotensin receptor/neprilysin inhibitor; ACEI, Angiotensin-converting enzyme inhibitor; CCB, calcium channel blocker.

Figure 2 ROC curve of TyG predicting long‐term MACEs in patients with advanced chronic heart.

Table 2 Clinical and Laboratory Characteristics According to the TyG (ACM)

Variables	Low TyG (n=330)	High TyG (n=387)	χ^2/t/z	P
Age>60, n (%)	159 (48.18)	201 (51.94)	χ²=1.01	0.316
Male, n (%)	227 (68.79)	209 (54.01)	χ²=16.33	<0.001
Coronary heart disease, n (%)	135 (40.91)	205 (52.97)	χ²=10.39	0.001
Hypertension, n (%)	230 (69.70)	266 (68.73)	χ²=0.08	0.781
Arrhythmia, n (%)	106 (32.12)	116 (29.97)	χ²=0.38	0.535
Diabetes, n (%)	89 (26.97)	159 (41.09)	χ²=15.69	<0.001
Hyperlipidemia, n (%)	2 (0.61)	14 (3.62)	χ²=7.40	0.007
Cerebrovascular disease, n (%)	55 (16.67)	74 (19.12)	χ²=0.73	0.394
Chronic kidney disease, n (%)	224 (67.88)	239 (61.76)	χ²=2.92	0.088
Peripheral vascular disease, n (%)	45 (13.64)	62 (16.02)	χ²=0.80	0.372
Thyroid disease, n (%)	74 (22.42)	71 (18.35)	χ²=1.84	0.175
Chronic lung disease, n (%)	69 (20.91)	90 (23.26)	χ²=0.57	0.451
Smoking history, n (%)	90 (27.27)	108 (27.91)	χ²=0.04	0.850
Drinking history, n (%)	64 (19.39)	63 (16.28)	χ²=1.19	0.276
White blood cell, 10^9/L	6.22 (5.12, 8.30)	7.01 (5.60, 9.40)	Z=−3.73	<0.001
Red blood cell, 10^9/L	3.42 (2.83, 4.14)	3.53 (2.94, 4.22)	Z=−1.73	0.083
Hemoglobin, g/L	104.60 (85.05, 126.00)	107.30 (86.00, 128.00)	Z=−1.16	0.247
Platelet, 10^9/L	176.50 (136.25, 225.00)	190.00 (139.50, 252.00)	Z=−2.51	0.012
Neutrophil, 10^9/L	4.44 (3.39, 6.14)	5.19 (3.88, 7.37)	Z=−4.11	<0.001
Lymphocyte, 10^9/L	1.04 (0.74, 1.44)	1.07 (0.75, 1.52)	Z=−0.93	0.351
Eosinophil, 10^9/L	0.09 (0.03, 0.19)	0.08 (0.03, 0.16)	Z=−1.19	0.233
Basophil, 10^9/L	0.03 (0.01, 0.04)	0.02 (0.01, 0.04)	Z=−0.56	0.573
Thrombin time, s	11.20 (10.40, 12.38)	11.00 (10.30, 12.40)	Z=−1.43	0.152
Fibrinogen, g/L	3.37 (2.84, 4.11)	3.67 (2.89, 4.54)	Z=−2.73	0.006
Blood urea nitrogen, mmol/L	17.55 (9.26, 26.10)	15.54 (8.50, 24.29)	Z=−1.58	0.115
Creatinine, μmol/L	381.50 (99.25, 787.75)	259.40 (100.00, 607.60)	Z=−2.26	0.024
Uric acid, mmol/L	391.00 (287.25, 482.00)	408.00 (305.50, 508.50)	Z=−1.58	0.114
eGFR, mL/(min/1.73 m^2)	12.43 (5.84, 61.00)	19.68 (6.59, 59.43)	Z=−1.85	0.065
Albumin, g/L	36.80 (33.12, 40.68)	35.90 (31.90, 40.30)	Z=−2.05	0.041
Globulin, g/L	27.75 (23.13, 32.90)	29.60 (25.20, 33.30)	Z=−2.96	0.003
Total bilirubin, μmol/L	8.30 (5.40, 14.84)	8.34 (5.45, 14.35)	Z=−0.02	0.984
Total cholesterol, mmol/L	3.46 (2.86, 4.15)	3.90 (3.21, 4.79)	Z=−5.82	<0.001
Triglyceride, mmol/L	0.78 (0.60, 1.01)	1.78 (1.30, 2.34)	Z=−19.65	<0.001
HDL-C, mmol/L	1.03 (0.84, 1.24)	0.90 (0.72, 1.16)	Z=−4.69	<0.001
LDL-C, mmol/L	1.98 (1.51, 2.57)	2.27 (1.64, 2.92)	Z=−3.54	<0.001
Troponin, ng/mL	0.04 (0.02, 0.09)	0.05 (0.02, 0.14)	Z=−3.68	<0.001
CK-MB ng/mL	13.00 (8.00, 18.00)	13.00 (7.00, 22.00)	Z=−1.08	0.280
C-reactive protein, mg/L	9.23 (2.82, 28.66)	10.66 (4.16, 33.10)	Z=−1.91	0.057
Blood glucose, mmol/L	4.66 (3.97, 5.73)	6.92 (5.27, 9.39)	Z=−12.98	<0.001
Glycosylated hemoglobin, %	5.70 (5.20, 6.10)	6.00 (5.50, 7.20)	Z=−6.95	<0.001
Aspirin, n (%)	103 (31.21)	134 (34.63)	χ²=0.94	0.333
Ticagrelor, n (%)	22 (6.67)	39 (10.08)	χ²=2.66	0.103
Clopidogrel, n (%)	46 (13.94)	77 (19.90)	χ²=4.45	0.035
ARNI, n (%)	98 (29.70)	85 (21.96)	χ²=5.60	0.018
ACEI, n (%)	154 (46.67)	161 (41.60)	χ²=1.85	0.173
Beta-blocker, n (%)	172 (52.12)	228 (58.91)	χ²=3.33	0.068
Diuretics, n (%)	129 (39.09)	173 (44.70)	χ²=2.30	0.129
Statins, n (%)	133 (40.30)	192 (49.61)	χ²=6.23	0.013
Digoxin, n (%)	39 (11.82)	43 (11.11)	χ²=0.09	0.767
CCB, n (%)	145 (43.94)	147 (37.98)	χ²=2.62	0.106

Notes: Continuous variables are expressed using the median and interquartile range (25%, 75%). Categorical variables are presented as case numbers (percentages).

Abbreviations: eGFR, estimated glomerular filtration rate; HDL-C, high density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol; CK-MB, creatine kinase-myoglobin binding; ARNI, angiotensin receptor/neprilysin inhibitor; ACEI, Angiotensin-converting enzyme inhibitor; CCB, calcium channel blocker.

Figure 3 ROC curve of TyG predicting long‐term ACM in patients with advanced chronic heart failure with renal dysfunction.

Table 3 Univariate COX Regression Analysis Results for MACEs

Variables	β	S.E	Wald χ^2	HR (95% CI)	P
Age>60	0.783	0.134	34.079	2.189 (1.683–2.847)	<0.001
Male	−0.386	0.128	9.066	0.68 (0.529–0.874)	0.003
Coronary heart disease	0.733	0.132	31.012	2.081 (1.608–2.694)	<0.001
Arrhythmia	0.727	0.13	31.482	2.069 (1.605–2.667)	<0.001
Diabetes	−0.013	0.135	0.01	0.987 (0.757–1.286)	0.922
Hyperlipidemia	0.514	0.36	2.039	1.671 (3.382–1.286)	0.153
Cerebrovascular disease	0.122	0.162	0.561	11.129 (0.821–1.553)	0.454
Chronic kidney disease	−0.838	0.128	42.619	0.433 (0.336–0.556)	<0.001
Hypertension	−0.181	0.047	15.117	0.834 (0.761–0.914)	<0.001
Chronic lung disease	0.667	0.137	23.7	1.948 (1.489–2.548)	<0.001
Smoking history	0.04	0.142	0.08	1.041 (0.788–1.376)	0.777
Drinking history	−0.001	0.17	0	0.999 (0.716–1.393)	0.995
White blood cell	0.045	0.014	9.568	1.046 (1.017–1.076)	0.002
Red blood cell	0.126	0.066	3.664	1.134 (0.997–1.29)	0.056
Hemoglobin	0.001	0.001	2.676	1.001 (1–1.002)	0.102
Platelet	0	0.001	0.013	1(0.999–1.002)	0.91
Neutrophil	0.018	0.009	4.417	1.018 (1.001–1.036)	0.036
Lymphocyte	−0.084	0.096	0.754	0.92 (0.761–1.111)	0.385
Eosinophil	−0.732	0.386	3.593	0.481 (0.225–1.025)	0.058
Basophil	0.146	0.275	0.283	1.158 (0.675–1.985)	0.595
Thrombin time	0.019	0.006	11.689	1.019 (1.008–1.03)	0.001
Fibrinogen	−0.015	0.044	0.121	0.985 (0.904–1.073)	0.728
Blood urea nitrogen	−0.026	0.006	15.936	0.975 (0.962–0.987)	<0.001
Creatinine	−0.002	0	52.686	0.998 (0.998–0.999)	<0.001
Uric acid	0.001	0	3.691	1.001 (1–1.001)	0.055
eGFR	0.009	0.002	26.208	1.009 (1.006–1.012)	<0.001
Albumin	−0.006	0.008	0.62	0.994 (0.979–1.009)	0.431
Globulin	0.004	0.002	4.321	1.004 (1–1.008)	0.038
Total bilirubin	0.009	0.002	21.975	1.009 (1.005–1.013)	<0.001
Total cholesterol	−0.006	0.034	0.028	0.994 (0.93–1.063)	0.866
Triglyceride	0.277	0.049	32.267	1.319 (1.199–1.451)	<0.001
HDL-C	0.054	0.089	0.367	1.055 (0.887–1.255)	0.544
LDL-C	−0.173	0.065	7	0.841 (0.74–0.956)	0.008
Troponin	0.048	0.016	8.953	1.049 (1.017–1.082)	0.003
CK-MB	0.007	0.002	14.859	1.007 (1.004–1.011)	<0.001
C-reactive protein	0.004	0.001	13.316	1.004 (1.002–1.006)	<0.001
Blood glucose	0.092	0.011	73.166	1.097 (1.074–1.12)	<0.001
Glycosylated hemoglobin	0.148	0.038	15.321	1.16 (1.077–1.249)	<0.001
Aspirin	0.373	0.131	8.11	1.452 (1.123–1.877)	0.004
Ticagrelor	0.235	0.208	1.281	1.265 (0.842–1.9)	0.258
Clopidogrel	0.734	0.147	25.054	2.084 (1.563–2.777)	<0.001
ARNI	−0.329	0.163	4.072	0.72 (0.523–0.991)	0.044
ACEI	−0.104	0.13	0.631	0.902 (0.698–1.164)	0.427
Beta-blocker	−0.039	0.129	0.09	0.962 (0.747–1.239)	0.764
Statins	0.481	0.129	13.933	1.617 (1.256–2.081)	<0.001
Diuretics	0.935	0.131	50.538	2.546 (1.968–3.295)	<0.001
Digoxin	0.514	0.173	8.81	1.672 (1.191–2.347)	0.003
CCB	−0.734	0.144	26.05	0.48 (0.362–0.636)	<0.001
TyG	1.648	0.173	90.598	5.198 (3.702–7.298)	<0.001

Abbreviations: eGFR, estimated glomerular filtration rate; HDL-C, high density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol; CK-MB, creatine kinase-myoglobin binding; ARNI, angiotensin receptor/neprilysin inhibitor; ACEI, Angiotensin-converting enzyme inhibitor; CCB, calcium channel blocker.

Table 4 Univariate COX Regression Analysis Results for ACM

Variables	β	S.E	Wald χ^2	HR (95% CI)	P
Age>60	1.123	0.181	38.596	3.075 (2.157–4.383)	<0.001
Male	−0.484	0.161	9.072	0.616 (0.45–0.844)	0.003
Coronary heart disease	0.638	0.165	15.039	1.893 (1.371–2.613)	<0.001
Arrhythmia	0.712	0.162	19.434	2.039 (1.485–2.799)	<0.001
Diabetes	−0.015	0.169	0.008	0.985 (0.707–1.373)	0.929
Hyperlipidemia	−0.184	0.583	0.1	0.832 (0.265–2.608)	0.752
Cerebrovascular disease	0.222	0.199	1.255	1.249 (0.846–1.843)	0.263
Chronic kidney disease	−0.634	0.161	15.554	0.531 (0.387–0.727)	<0.001
Hypertension	−0.863	0.161	28.796	0.422 (0.308–0.578)	<0.001
Chronic lung disease	0.687	0.169	16.442	1.987 (1.426–2.77)	<0.001
Smoking history	−0.087	0.182	0.229	0.916 (0.641–1.31)	0.632
Drinking history	−0.119	0.218	0.296	0.888 (0.579–1.362)	0.586
White blood cell	0.06	0.017	12.224	1.062 (1.027–1.099)	<0.001
Red blood cell	0.064	0.084	0.581	1.066 (0.904–1.258)	0.446
Hemoglobin	0.001	0.001	2.267	1.001 (1–1.003)	0.132
Platelet	−0.001	0.001	1.646	0.999 (0.997–1.001)	0.2
Neutrophil	0.025	0.009	7.429	1.025 (1.007–1.043)	0.006
Lymphocyte	−0.364	0.147	6.146	0.695 (0.521–0.927)	0.013
Eosinophil	−2.317	0.723	10.269	0.099 (0.024–0.407)	0.001
Basophil	0.221	0.313	0.5	1.247 (0.676–2.303)	0.48
Thrombin time	0.022	0.006	11.778	1.022 (1.009–1.035)	0.001
Fibrinogen	−0.138	0.072	3.627	0.871 (0.756–1.004)	0.057
Blood urea nitrogen	−0.007	0.007	0.88	0.993 (0.979–1.007)	0.348
Creatinine	−0.001	0	24.206	0.999 (0.998–0.999)	<0.001
Uric acid	0.001	0	9.892	1.001 (1.001–1.002)	0.002
eGFR	0.004	0.002	3.69	1.004 (1–1.009)	0.055
Albumin	−0.032	0.012	7.268	0.969 (0.946–0.991)	0.007
Globulin	0.002	0.003	0.289	1.002 (0.995–1.008)	0.591
Total bilirubin	0.011	0.002	28.069	1.011 (1.007–1.015)	<0.001
Total cholesterol	0.006	0.04	0.024	1.006 (0.931–1.087)	0.878
Triglyceride	0.236	0.066	12.661	1.266 (1.112–1.442)	<0.001
HDL-C	0.1	0.09	1.253	1.106 (0.927–1.318)	0.263
LDL-C	−0.223	0.085	6.867	0.8 (0.677–0.945)	0.009
Troponin	0.059	0.016	12.723	1.061 (1.027–1.095)	<0.001
CK-MB	0.008	0.002	17.687	1.008 (1.004–1.011)	<0.001
C-reactive protein	0.005	0.001	20.836	1.005 (1.003–1.007)	<0.001
Blood glucose	0.081	0.014	33.216	1.085 (1.055–1.115)	<0.001
Glycosylated hemoglobin	0.107	0.049	4.818	1.113 (1.012–1.225)	0.028
Aspirin	0.159	0.167	0.901	1.172 (0.844–1.627)	0.342
Ticagrelor	−0.066	0.29	0.051	0.936 (0.531–1.653)	0.821
Clopidogrel	0.628	0.184	11.667	1.873 (1.307–2.685)	0.001
ARNI	−0.393	0.206	3.632	0.675 (0.45–1.011)	0.057
ACEI	−0.311	0.167	3.486	0.733 (0.528–1.016)	0.062
Beta-blocker	−0.297	0.161	3.414	0.743 (0.542–1.018)	0.065
Statins	0.171	0.161	1.128	1.186 (0.866–1.625)	0.288
Diuretics	0.754	0.163	21.349	2.126 (1.544–2.927)	<0.001
Digoxin	0.539	0.212	6.479	1.715 (1.132–2.597)	0.011
CCB	−0.872	0.189	21.385	0.418 (0.289–0.605)	<0.001
TyG	1.495	0.209	51.243	4.461 (2.962–6.718)	<0.001

Abbreviations: eGFR, estimated glomerular filtration rate; HDL-C, high density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol; CK-MB, creatine kinase-myoglobin binding; ARNI, angiotensin receptor/neprilysin inhibitor; ACEI, Angiotensin-converting enzyme inhibitor; CCB, calcium channel blocker.

Table 5 Multivariate Cox Regression Analysis Results for MACEs

Variables	Beta	S.E	Wald χ^2	HR (95% CI)	P
Age>60	0.479	0.155	9.611	1.614 (1.193–2.185)	0.002
Male	−0.165	0.161	1.038	0.848 (0.618–1.164)	0.308
Coronary heart disease	0.129	0.162	0.638	1.138 (0.829–1.562)	0.424
Arrhythmia	0.436	0.146	8.919	1.547 (1.162–2.059)	0.003
Chronic kidney disease	−0.13	0.158	0.676	0.878 (0.645–1.197)	0.411
Chronic lung disease	0.217	0.147	2.179	1.243 (0.931–1.658)	0.14
Hypertension	−0.083	0.053	2.446	0.92 (0.829–1.021)	0.118
Glycosylated hemoglobin	−0.048	0.044	1.213	0.953 (0.874–1.039)	0.271
Aspirin	0.104	0.156	0.44	1.109 (0.817–1.506)	0.507
Clopidogrel	0.173	0.165	1.099	1.189 (0.86–1.644)	0.295
ARNI	−0.134	0.172	0.607	0.875 (0.625–1.225)	0.436
Statins	0.09	0.162	0.311	1.094 (0.797–1.502)	0.577
Diuretics	0.307	0.165	3.461	1.36 (0.984–1.879)	0.063
Digoxin	0.153	0.193	0.627	1.165 (0.798–1.701)	0.428
CCB	−0.223	0.165	1.821	0.8 (0.579–1.106)	0.177
TyG	1.687	0.183	84.567	5.402 (3.771–7.739)	0
Smoking history	−0.063	0.181	0.119	0.939 (0.658–1.34)	0.73
LDL-C	−0.158	0.07	5.06	0.854 (0.744–0.98)	0.024
HDL-C	0.081	0.072	1.247	1.084 (0.941–1.249)	0.264
Total cholesterol	0.009	0.027	0.103	1.009 (0.957–1.062)	0.749
C-reactive protein	0.002	0.001	4.657	1.002 (1–1.005)	0.031

Abbreviations: HDL-C, high density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol; ARNI, angiotensin receptor/neprilysin inhibitor; CCB, calcium channel blocker.

Table 6 Multivariate Cox Regression Analysis Results for ACM

Variables	Beta	S.E	Wald χ^2	HR (95% CI)	P
Age>60	0.936	0.203	21.215	2.549 (1.712–3.797)	0
Male	−0.259	0.202	1.642	0.772 (0.519–1.147)	0.2
Coronary heart disease	0.073	0.198	0.137	1.076 (0.73–1.585)	0.711
Arrhythmia	0.407	0.183	4.946	1.502 (1.049–2.149)	0.026
Chronic kidney disease	0.121	0.196	0.377	1.128 (0.768–1.658)	0.539
Chronic lung disease	0.259	0.183	2.017	1.296 (0.906–1.854)	0.156
Hypertension	−0.209	0.066	10.157	0.811 (0.714–0.923)	0.001
Glycosylated hemoglobin	−0.109	0.057	3.659	0.897 (0.802–1.003)	0.056
Aspirin	0.064	0.203	0.099	1.066 (0.716–1.586)	0.753
Clopidogrel	0.256	0.212	1.46	1.292 (0.853–1.959)	0.227
ARNI	−0.06	0.219	0.076	0.942 (0.613–1.445)	0.783
Statins	−0.276	0.204	1.84	0.759 (0.509–1.131)	0.175
Diuretics	0.089	0.206	0.186	1.093 (0.73–1.635)	0.666
Digoxin	0.227	0.237	0.918	1.255 (0.788–1.999)	0.338
CCB	−0.331	0.213	2.42	0.718 (0.473–1.09)	0.12
Smoking history	−0.073	0.23	0.101	0.929 (0.592–1.459)	0.751
LDL-C	−0.222	0.089	6.225	0.801 (0.673–0.953)	0.013
HDL-C	0.13	0.084	2.389	1.139 (0.966–1.342)	0.122
Total cholesterol	0.024	0.029	0.682	1.025 (0.967–1.085)	0.409
C-reactive protein	0.004	0.001	9.689	1.004 (1.001–1.006)	0.002
TyG	1.622	0.223	52.795	5.062 (3.268–7.839)	0

Abbreviations: HDL-C, high density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol; ARNI, angiotensin receptor/neprilysin inhibitor; CCB, calcium channel blocker.

Figure 4 Kaplan–Meier curves for survival analysis of MACEs-free survival (Log rang p<0.001).

Figure 5 Kaplan–Meier curves for survival analysis of ACM-free survival (Log rang p<0.001).

Data Sharing Statement

The data that support the findings of this study are available on request from the corresponding author, upon reasonable request.