Cardiovascular drugs and therapy · 2026
Combined Prognostic Value of Triglyceride-Glucose Index and Bilirubin in Drug-Eluting Stent Restenosis: From Clinical Risk Stratification to Exploratory Vascular-Cell Findings.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wu Yingle, Qu Xiaopeng, Han Yanhui, Fan Mengnan, Yang Xuming, Dong Pingshuan, Wang Ke, Du Laijing
Аннотация
BACKGROUND: Drug-eluting stent in-stent restenosis (DES-ISR) remains a clinically relevant complication after percutaneous coronary intervention for acute coronary syndrome (ACS). We assessed the combined predictive value of the triglyceride-glucose (TyG) index and total bilirubin (TB), alongside exploratory vascular-cell findings.
METHODS: This retrospective cohort included 1,160 ACS patients undergoing drug-eluting stent implantation and angiographic follow-up. Associations with DES-ISR, discrimination, calibration, and incremental prediction were evaluated using multivariable models and split-sample internal validation. HUVECs and VSMCs were exposed to high-glucose/high-triglyceride or bilirubin-related conditions; network pharmacology, reverse docking, and selected pathway experiments were used to generate and evaluate hypotheses.
RESULTS: Higher TyG was associated with increased DES-ISR risk (adjusted OR = 1.487, 95% CI 1.067-2.073), whereas higher TB was associated with lower risk (OR = 0.875, 95% CI 0.838-0.914). The TyG-TB model had AUCs of 0.702 (training) and 0.676 (validation), with Brier score 0.134, calibration slope 0.858, and Hosmer-Lemeshow P = 0.868. Adding TyG and TB improved prediction (ΔAUC = 0.078; continuous NRI = 0.714; IDI = 0.060; all P < 0.001). High-glucose/high-triglyceride exposure was associated with proliferative, oxidative, RAGE/NF-κB/MAPK-related, and insulin-response changes; FPS-ZM1 attenuated selected responses.
CONCLUSION: TyG and TB showed opposite associations with DES-ISR and jointly provided moderate incremental predictive information. The cell findings support RAGE-related vascular responses under the tested conditions but require external and mechanistic validation before clinical application.
METHODS: This retrospective cohort included 1,160 ACS patients undergoing drug-eluting stent implantation and angiographic follow-up. Associations with DES-ISR, discrimination, calibration, and incremental prediction were evaluated using multivariable models and split-sample internal validation. HUVECs and VSMCs were exposed to high-glucose/high-triglyceride or bilirubin-related conditions; network pharmacology, reverse docking, and selected pathway experiments were used to generate and evaluate hypotheses.
RESULTS: Higher TyG was associated with increased DES-ISR risk (adjusted OR = 1.487, 95% CI 1.067-2.073), whereas higher TB was associated with lower risk (OR = 0.875, 95% CI 0.838-0.914). The TyG-TB model had AUCs of 0.702 (training) and 0.676 (validation), with Brier score 0.134, calibration slope 0.858, and Hosmer-Lemeshow P = 0.868. Adding TyG and TB improved prediction (ΔAUC = 0.078; continuous NRI = 0.714; IDI = 0.060; all P < 0.001). High-glucose/high-triglyceride exposure was associated with proliferative, oxidative, RAGE/NF-κB/MAPK-related, and insulin-response changes; FPS-ZM1 attenuated selected responses.
CONCLUSION: TyG and TB showed opposite associations with DES-ISR and jointly provided moderate incremental predictive information. The cell findings support RAGE-related vascular responses under the tested conditions but require external and mechanistic validation before clinical application.