Association between the preoperative triglyceride-glucose index and myocardial injury following non-cardiac surgery: a cross-sectional study

Objective An elevated triglyceride-glucose (TyG) index positively correlates with adverse cardiovascular events. However, its association with myocardial injury after non-cardiac surgery (MINS) remains unclear. This study aimed to examine the association between the preoperative TyG index and MINS. Design A cross-sectional study. Setting Meizhou People’s Hospital. Participants Adult patients under general anaesthesia and with MINS. Main exposure measure The preoperative TyG index, calculated using triglyceride (TG) and fasting blood glucose (FBG) levels. Main outcome measure The occurrence of MINS, defined using postoperative troponin measurements. Results 889 patients were included, with an 8.3% incidence of MINS (74/889). The median TyG index was 8.57 (8.13, 9.02). TyG exhibited higher discriminatory ability for MINS than TG and FBG, with an area under the curve of 0.624, 0.544 and 0.500, respectively. Fully adjusted logistic regression indicated that an elevated TyG index was independently associated with MINS (OR 1.75, 95% CI 1.21 to 2.52; p=0.003). A multivariate restricted cubic spline suggested a linear relationship between TyG and MINS (p value for non-linearity=0.059). Subgroup analyses showed results consistent with the primary analysis, with no significant interaction effects between subgroups. Conclusion An elevated preoperative TyG index is independently associated with an increased incidence of MINS. Monitoring the TyG index perioperatively may improve the management of patients at risk for MINS. Trial registration number ChiCTR2400082834.