Introduction

The triglyceride–glucose (TyG) index is a simple surrogate marker of insulin resistance that has been associated with adverse cardiovascular outcomes. However, its prognostic value in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) remains incompletely defined.

Aim

To investigate the association between the TyG index and 1-year major adverse cardiovascular events (MACE) in STEMI patients.

Material and methods

This study included 757 consecutive STEMI patients who underwent primary PCI between 2019 and 2023. The TyG index was calculated using fasting triglyceride and glucose levels. Patients were stratified according to the median TyG value (9.24). The primary endpoint was MACE, defined as a composite of cardiovascular hospitalisation, stroke, non-fatal myocardial infarction, and all-cause mortality. Logistic regression and receiver operating characteristic (ROC) analyses were performed

Results

MACE occurred in 279 (36.8%) patients. Patients in the high-TyG group had a significantly higher incidence of MACE than those in the low-TyG group (41.8% vs. 31.9%, respectively, p = 0.003). In multivariable analysis, a high TyG index remained independently associated with MACE (OR = 1.548, 95% CI: 1.100–2.179, p = 0.012). ROC analysis demonstrated a statistically significant but modest discriminatory performance for MACE prediction (AUC = 0.573, 95% CI: 0.532–0.615, p = 0.001), with an optimal cut-off value of 9.38.

Conclusions

A higher TyG index was independently associated with an increased risk of 1-year MACE in STEMI patients undergoing primary PCI. Although its standalone discriminative performance was modest, the TyG index may provide complementary prognostic information and serve as a simple adjunctive tool for risk stratification.