Association between TG/HDL-C ratio or triglyceride-glucose index and mean arterial pressure in patients with myocardial infarction

Triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio and the triglyceride-glucose (TyG) index have become novel and convenient indicators of insulin resistance (IR) and are reported to be associated with occurrence and prognosis of myocardial infarction (MI). Mean arterial pressure (MAP) is another MI indicator that affects myocardial perfusion and oxygen delivery. However, the association between TG/HDL-C ratio and TyG index with MAP in patients with MI remains unclear. The purpose of this study was to explore the correlation between TG/HDL-C ratio and TyG index with MAP in patients with MI, which may provide valuable insights for the clinical assessment and management of MI patients. A total of 7341 patients with MI from January 2019 to December 2020 were enrolled to collect the general clinical data. Univariate and multivariate linear regression analyses were employed to examine the relationships between TG/HDL-C ratio and TyG index with MAP. Generalized additive models (GAM) and threshold effects analysis were applied to explore dose-response patterns. Gender and age interactions were tested. The average age of the 7341 patients with MI was 61.39 ± 13.13, and 62.23% were male. Both TG/HDL-C ratio and TyG index were positively associated with MAP. GAM analysis revealed that TG/HDL-C ratio showed non-linear associations with a threshold at 1.43, while TyG index demonstrated consistent linear relationships. Below the threshold, each unit increase in TG/HDL-C ratio was associated with 2.23 mmHg increase in MAP (95%CI: 0.76-3.71, P = 0.0029); above threshold, associations were attenuated (P = 0.2021). TyG index showed linear association throughout its range (β = 0.30, 95%CI: 0.16-0.44, P < 0.0001). Both markers demonstrated stronger associations in male patients (P for interaction = 0.027). TG/HDL-C ratio and TyG index were positively associated with MAP in MI patients, showing threshold-based and linear patterns respectively. Both markers exhibited stronger associations in males. Monitoring these IR markers with consideration of threshold effects and gender differences deserves attention in clinical practice for MI management.