TyG Index is Associated with Major Adverse Cardiovascular Events in HIV-Infected Individuals with Cardiovascular Disease: A Single-Center Retrospective Cohort Study.

OBJECTIVE

To explore the correlation between triglyceride-to-glucose (TyG) ratio and major adverse cardiovascular events (MACE) risk in coronary artery disease complicated with human immunodeficiency virus (CAD-HIV) patients, and assess its predictive value.

METHODS

A single-center retrospective cohort study was conducted. A total of 103 CAD-HIV patients admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2020 to June 2025 were enrolled, with a follow-up of 5-49 months (median 22.00 months). Patients were grouped by MACE occurrence. Baseline data and TyG index were collected, with MACE as the primary endpoint. Cox regression, restricted cubic spline (RCS), ROC curve and subgroup analysis were performed.

RESULTS

Forty-one patients (39.81%) developed MACE, with significantly higher TyG index in the MACE group (P < 0.001). Multivariate Cox analysis showed each 0.1-unit elevation in TyG index increased MACE risk by 42% (HR = 1.42, 95% CI: 1.16-1.74, P < 0.001). Compared with Q1, Q3 and Q4 had 4.42-fold (95% CI: 1.17-16.68, P = 0.028) and 6.17-fold (95% CI: 1.77-21.54, P = 0.004) higher risk. RCS verified linear positive correlation (P for overall = 0.006, P for nonlinear = 0.387). AUC for 1-year and 3-year MACE prediction was 0.745 and 0.805, respectively. The association was stronger in non-smokers (P for interaction = 0.006).

CONCLUSION

TyG index is linearly associated with MACE risk in CAD-HIV patients and shows favorable predictive performance for 1-year and 3-year MACE, which can be used as a simple biomarker for cardiovascular risk stratification.