Association between TyG-related indices and in-hospital acute heart failure in patients with acute myocardial infarction after emergency percutaneous coronary intervention.

Levels of TyG index, TyG-BMI, TyG-WHtR, and TyG-WC were significantly higher in AMI patients who developed in-hospital acute heart failure after emergency PCI.

• A total of 885 patients with AMI who underwent emergency PCI were enrolled in this retrospective study from January 2023 to December 2025.
• All four TyG-related indices were elevated in the AHF group compared to the non-AHF group.
• LASSO regression identified 12 risk variables from the dataset for further analysis.

TyG-WHtR was independently associated with a significantly elevated risk of in-hospital acute heart failure.

• Logistic regression demonstrated OR: 2.29, 95% CI: 1.35-3.91, P < 0.01 for TyG-WHtR and AHF.
• This association was identified after adjustment for relevant covariates.
• TyG-WHtR was characterized as a relatively important and independent predictor among the TyG-related indices studied.

TyG-WHtR exhibited relatively high discriminative performance for in-hospital acute heart failure as measured by ROC curve analysis.

• The area under the curve (AUC) for TyG-WHtR was 0.759 (95% CI: 0.721-0.797).
• This AUC was described as indicating 'relatively high discriminative performance for AHF'.
• ROC curve analysis was used to compare discriminative ability across TyG-related indices.

Higher quartiles of all four TyG-related indices were significantly associated with increased risk of acute heart failure.

• TyG-related indices were stratified and analyzed by quartiles.
• Higher quartiles were significantly associated with an increased risk of AHF across all models for TyG, TyG-BMI, TyG-WHtR, and TyG-WC.
• This pattern was consistent across multiple analytical models.

Restricted cubic spline models revealed linear relationships between all four TyG-related indices and acute heart failure.

• Linear relationships were found between TyG, TyG-BMI, TyG-WHtR, TyG-WC and AHF following adjustment for covariates.
• P-overall < 0.05 and P-nonlinear > 0.05, confirming linearity rather than non-linearity.
• These linear dose-response relationships were observed after covariate adjustment.

TyG-BMI was more strongly associated with incident AHF among patients with the left anterior descending artery as the culprit vessel.

• Subgroup analysis revealed a significant interaction between TyG-BMI and culprit vessel type.
• P for interaction < 0.05 for the LAD subgroup.
• This interaction was identified through pre-specified subgroup analyses examining potential effect modifiers.