METS-IR and TyG-BMI were independently associated with PH presence (OR 1.069, 1.015); METS-IR, TG/HDL-C, and TyG-BMI predicted transplant-free survival in PH-HF patients.
Are non-insulin-based insulin resistance indices associated with the presence and outcomes of pulmonary hypertension due to left heart failure?
Non-insulin-based insulin resistance indices are independently associated with the presence of pulmonary hypertension and predict transplant-free survival in patients with left heart failure.
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Abstract Background Insulin resistance (IR) has been reported to have a close relationship with the development and adverse outcomes of various cardiovascular disorders, while its association with pulmonary hypertension due to left heart failure (PH-HF) remains to be elucidated. Purpose To explore the association between IR and the presence and outcomes of PH-HF. Methods A retrospective analysis of a prospective cohort of patients with left heart failure undergoing right heart catheterization was performed. The primary endpoint was all-cause mortality or transplantation. PH-HF was hemodynamically defined as a mean pulmonary arterial pressure 20 mmHg and a pulmonary arterial wedge pressure＞15 mmHg. IR is quantified by four non-insulin-based indices, including the metabolic score for IR (METS-IR), triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, triglyceride and glucose (TyG) index, and triglyceride-glucose-body mass index (TyG-BMI). The correlation between IR indices and the presence of pulmonary hypertension was determined by Logistics regression models. Cox proportional hazards models and restricted cubic splines were used to identify the association between variables and the primary endpoint. Results A total of 242 patients with heart failure were enrolled, and 149 patients were classified as PH-HF. During a median follow-up of 25.1 months, 51 patients met the primary endpoint. In multivariate Logistics analysis, METS-IR (odds ratio: 1.069, 95% confidence interval: 1.013-1.130，p=0.016) and TyG-BMI (odds ratio:1.015, 95% confidence interval: 1.003-1.027，p=0.011) were independently associated with the presence of pulmonary hypertension. Among patients with PH-HF, Cox regression analyses indicated that METS-IR (hazard ratio: 0.946, 95% confidence interval: 0.913-0.979，p=0.002), TG/HDL-C (hazard ratio: 0.839, 95% confidence interval: 0.706-0.996，p=0.045) and TyG-BMI (hazard ratio: 0.988, 95% confidence interval: 0.981-0.995，p=0.001) could independently predict transplant-free survival. Conclusion IR is associated with the presence of pulmonary hypertension in patients with left heart failure, and IR indices could be outcome predictors for patients with PH-HF.Table 1 Figure 1
Quan et al. (Sat,) reported a other. METS-IR and TyG-BMI were independently associated with PH presence (OR 1.069, 1.015); METS-IR, TG/HDL-C, and TyG-BMI predicted transplant-free survival in PH-HF patients.
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