Association Between Triglyceride-Glucose Index and Incomplete Device Endothelialization After Left Atrial Appendage Occlusion: A Retrospective Observational Study.

BACKGROUND

The triglyceride-glucose (TyG) index, a biomarker for insulin resistance, has been shown to be associated with cardiovascular diseases. However, its association with delayed device endothelialization after left atrial appendage occlusion (LAAO) has not yet been explored.

METHODS

This retrospective study included 594 patients with non-valvular atrial fibrillation (NVAF) who underwent LAAO with the Watchman2.5 device at the Electrophysiology Center of Taizhou People's Hospital, Nanjing Medical University. Postoperative follow-up was performed at 3 months using Contrast-Enhanced Computed Tomography Angiography (CCTA). Patients were grouped based on quartiles of the TyG index. Logistic regression analysis and restricted cubic spline (RCS) regression models were used to evaluate the association between the TyG index and incomplete device endothelialization (IDE) postprocedure.

RESULTS

The TyG index was divided into four groups based on quartiles, with Group 1 (TyG index ≤ 8.17) serving as the reference. In Groups 3 (8.32 < TyG index ≤ 8.50) and 4 (TyG index > 8.50), the TyG index was identified as an independent risk factor for IDE postprocedure. The RCS model confirmed a significant linear relationship between the TyG index and IDE postprocedure. Furthermore, the association between the TyG index and IDE was consistent across different subgroups.

CONCLUSION

A higher TyG index was significantly associated with IDE after LAAO, suggesting that it could serve as a simple, cost-effective biomarker for predicting the risk of IDE in this population.