Joint effects of depressive symptoms and triglyceride-glucose index on cardiovascular events in acute coronary syndrome patients: The mediating role of TyGi

Abstract

Objective

Our aim was to explore the joint impacts of depressive symptoms along with triglyceride-glucose index (TyGi) on major adverse cardiovascular events (MACE) in patients who have acute coronary syndrome (ACS) and investigate whether the impact of depressive symptoms on MACE is mediated through the TyGi.

Methods

This extensive cohort study included 3681 ACS patients. Depressive symptoms and TyGi were assessed at baseline, and the patients were subsequently followed for two years to monitor the occurrence of MACE.

Results

Throughout the two-year monitoring period, 387 (10.5 %) patients with ACS experienced MACE. The TyGi was positively correlated with MACE risk (hazard ratio [HR]: 1.301, 95 % confidence interval [CI]: 1.112–1.522, p = .001). A nonlinear relation was observed between the TyGi and MACE (p for nonlinearity = 0.04). Joint analyses revealed that, unlike the non-depression & TyG low group, the depression & TyG low group had a two-fold elevation in MACE risk (HR: 2.108, 95 % CI: 1.499–2.966), while the depression & TyG high group represented an even higher risk (HR: 2.442, 95 % CI: 1.786–3.339). The mediation analysis results showcased that the TyGi was a significant mediator of the interplay between depressive symptoms and MACE.

Conclusion

Depressive symptoms and the TyGi jointly influence MACE risk in ACS patients, with the TyGi mediating this relation. Close monitoring and management of depressive symptoms and the TyGi are crucial during ACS rehabilitation.