甘油三酯葡萄糖指数对心房颤动射频消融术后晚期复发的应用价值

Application of triglyceride-glucose index to late recurrence after radiofrequency catheter ablation of atrial fibrillation

目的探讨甘油三酯葡萄糖指数(TyG指数)在非糖尿病持续性房颤(PeAF)患者导管射频消融(RFCA)术后晚期复发方面的临床意义及应用价值。方法回顾性分析2020年1月至2021年8月于郑州市第七人民医院与河南省胸科医院心血管内科就诊,首次行RFCA治疗的242例非糖尿病PeAF患者的临床资料,于术后1、3、6、12个月定期随访患者房颤复发情况。根据RFCA术后3个月至1年内是否复发将患者分为未复发组(190例)和复发组(52例)。采用SPSS 26.0与GraphPad 9.0软件进行统计与绘图。根据数据类型,分别采用t检验、Mann-Whitney U检验、χ^(2)检验或校正χ^(2)检验进行组间比较。采用多因素Cox回归分析非糖尿病PeAF患者晚期复发的独立危险因素及TyG指数对术后复发的预测价值。结果复发组PeAF病史更久,更倾向合并冠状动脉粥样硬化性心脏病(CAD),左心房内径(LAD)、TyG指数明显更大,术后未应用血管紧张素受体脑啡肽酶抑制剂(ARNI)治疗的比例更高(P<0.05)。PeAF病史、CAD、LAD、术后应用ARNI和TyG指数是术后1年内复发的独立影响因素(P<0.05)。TyG指数较高的非糖尿病PeAF患者晚期更易复发。结论TyG指数对非糖尿病PeAF患者RFCA术后晚期复发具有良好的预测价值,对PeAF患者的综合管理具有一定的指导意义。

Objective To investigate the clinical implications and application value of triglyceride-glucose(TyG)index in late recurrence after radiofrequency catheter ablation(RFCA)in the non-diabetic patients with persistent atrial fibrillation(PeAF).Methods The clinical data were retrospectively reviewed of 242 non-diabetic PeAF patients,who received RFCA for the first time at Cardiology Department in Seventh People′s Hospital of Zhengzhou and Henan Provincial Chest Hospital from January 2020 to August 2021.The patients were regularly monitored for recurrence at 1,3,6 and 12 months following the procedure,and according to recurrence within 3-12 months,they were divided into non-recurrence group(n=190)and recurrence group(n=52).Statistics and graphics were performed using SPSS statistics 26.0 and GraphPad 9.0.Depending on data type,t test,Mann-Whitney U test,χ^(2) test or adjustedχ^(2) test was used for comparison between groups.Multifactorial Cox regression was used for analyzing independent risk factors for late recurrence and the predictive value of TyG index for postoperative recurrence in the non-diabetic PeAF patients.Results The recurrence group had a longer PeAF history with a higher tendency to develop coronary artery disease(CAD),a significantly larger left atrial diameter(LAD),a higher TyG index,and a higher proportion of patients not treated with angiotensin receptor neprilysin inhibitor(ARNI)(P<0.05).PeAF history,CAD,LAD,postoperative ARNI treatment and TyG index were independent risk factors for recurrence(P<0.05).Non-diabetic PeAF patients with higher TyG index were more prone to recurrence.Conclusion TyG index has a good predictive value for late recurrence after RFCA in non-diabetic PeAF patients,providing significant guidance for their comprehensive management.