LDL-C联合TyG指数对急性心肌梗死PCI后 早期心力衰竭的预测价值

The Predictive Value of Low-Density Lipoprotein Cholesterol Combined with Triglyceride-Glucose Index for Early Heart Failure Following Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction

摘要: 目的：心力衰竭(HF)是急性心肌梗死(AMI)患者常见且严重的并发症，早期识别心力衰竭高危患者对改善预后至关重要。本研究探讨AMI患者中低密度脂蛋白胆固醇(LDL-C)联合TyG指数对急性心肌梗死后早期心力衰竭发生的预测价值方法：本研究回顾性纳入2022年10月至2024年10月青岛大学附属医院546例AMI患者，根据30天内是否发生心力衰竭分组。采用二元Logistic回归分析早期心衰的独立危险因素，并绘制LDL-C、TyG指数及二者联合变量的ROC曲线，评估其对AMI后早期心衰的预测价值。结果：年龄、LDL-C、Gensini评分、LVEF、TyG指数、空腹血糖是AMI后早期心衰的独立危险因素(P < 0.05)。ROC分析显示：LDL-C的AUC为0.619，TyG的AUC为0.676，二者联合的AUC为0.723。本研究表明LDL-C联合TyG对AMI后早期心衰的预测价值更高。结论：LDL-C、TyG指数可作为AMI患者发生早期心力衰竭的独立危险因素，二者联合检测对AMI后发生早期心力衰竭的预测价值高于单独检测LDL-C、TyG指数的预测价值。

Abstract: Objective: Heart failure (HF) is a common and serious complication in patients with acute myocardial infarction (AMI). Early identification of high-risk patients for HF is crucial for improving prognosis. This study aimed to investigate the predictive value of low-density lipoprotein cholesterol (LDL-C) combined with the TyG index for the occurrence of early heart failure after AMI. Methods: This study retrospectively included 546 AMI patients from the Affiliated Hospital of Qingdao University between October 2022 and October 2024. Patients were divided into groups based on whether they developed heart failure within 30 days. Binary logistic regression analysis was used to identify independent risk factors for early heart failure. Receiver operating characteristic (ROC) curves were plotted for LDL-C, the TyG index, and their combination to evaluate their predictive value for early heart failure after AMI. Results: Age, LDL-C, Gensini score, LVEF, TyG index, and fasting blood glucose were independent risk factors for early heart failure after AMI (P < 0.05). ROC analysis showed that the area under the curve (AUC) for LDL-C was 0.619, for the TyG index was 0.676, and for their combination was 0.723. This study indicates that the combination of LDL-C and the TyG index has higher predictive value for early heart failure after AMI. Conclusion: LDL-C and the TyG index can serve as independent risk factors for early heart failure in AMI patients. The combined detection of these two markers has a higher predictive value for early heart failure after AMI than either LDL-C or the TyG index alone.