Association between triglyceride glucose body mass index and the prognosis of patients with atrial fibrillation complicated with acute coronary syndrome: a prospective study

The triglyceride-glucose body mass index (TyG-BMI) is a reliable marker of insulin resistance and has been linked to cardiovascular outcomes. However, data on the relationship between TyG-BMI and prognosis in patients with atrial fibrillation (AF) complicated by acute coronary syndrome (ACS) are limited. This study aimed to evaluate the association between baseline TyG-BMI and prognosis in AF-ACS patients. We conducted a single-center prospective analysis of 832 AF-ACS patients hospitalized at Fuwai Hospital from January 2017 to December 2019. The primary outcome was the incidence of major adverse cardio-cerebrovascular events (MACCEs) during the 1-year follow-up. Kaplan-Meier curves compared MACCE risk across four TyG-BMI quartiles. Cox proportional hazards regression and restricted cubic spline (RCS) analyses assessed the relationship between TyG-BMI and patient outcomes. The mean age of participants was 68.15 ± 9.59 years, with 569 (68.39%) being male. Kaplan-Meier analysis showed significant differences in 1-year MACCE risk between the four groups. Cox regression revealed that patients in the lowest TyG-BMI quartile had a significantly higher 1-year MACCE risk. RCS analysis indicated a linear increase in MACCE risk with decreasing TyG-BMI. TyG-BMI is closely associated with the prognosis of AF-ACS patients. Lower TyG-BMI is significantly linked to a higher risk of MACCEs in this population.