Высокий индекс TyG-BMI повышает риск смерти и госпитализаций у пациентов после операции при гипертрофической обструктивной кардиомиопатии

Elevated triglyceride glucose-body mass index (TyG-BMI) is associated with increased risk for worse long-term clinical outcomes among patients with hypertrophic obstructive cardiomyopathy (HOCM) after septal myectomy, according to study findings published in Frontiers in Endocrinology. TyG-BMI, which reflects both lipid-glucose metabolism and adiposity, has been associated with risks for adverse outcomes across multiple cardiovascular conditions in prior studies, although it is unclear whether those findings apply to patients after septal myectomy for HOCM. In a retrospective cohort study, researchers examined the association between TyG-BMI and clinical outcomes in patients with HOCM who underwent septal myectomy. Eligible participants had HOCM and underwent septal myectomy at Fuwai Hospital in China between 2013 and 2018. Given its significant relationship with clinical outcomes, TyG-BMI may serve as an accessible adjunctive marker of metabolic risk, but its clinical utility requires external validation. Patients were categorized into groups based on TyG-BMI tertiles: T1 (<205.40), T2 (205.40-233.30), and T3 (>233.30). Ventilation time, the length of the stay in the intensive care unit (ICU), and the length of the postoperative hospital stay were all significantly shorter in patients with higher TyG-BMI values (P <.05). The primary endpoint was a composite of heart failure hospitalization or all-cause death. Through a median follow-up of 4.3 years, the cumulative incidence of the endpoint was increased at higher TyG-BMI values, with 20 total events in T1, 33 in T2, and 42 in T3. Cox regression analysis showed that patients in T3 vs T1 had double the risk for heart failure hospitalization (adjusted hazard ratio [HR], 2.00; 95% CI, 1.16-3.44) and more than 3-fold greater risk for all-cause death (adjusted HR, 3.39; 95% CI, 1.34-8.58). Differences in heart failure hospitalization (adjusted HR, 1.60; 95% CI, 0.91-2.82) and all-cause death (adjusted HR, 2.52; 95% CI, 0.96-6.59) did not reach statistical significance between patients in T1 and T2. A total of 1302 patients (mean age, 49.2 years; 61% men; mean BMI, 25.6) were included in the analysis. When examining TyG-BMI as a continuous variable, higher values were tied to greater risks for both heart failure hospitalization (adjusted HR, 1.007; 95% CI, 1.002-1.012) and all-cause death (adjusted HR, 1.013; 95% CI, 1.006-1.021). The findings were generally consistent across subgroups, although there was a significant interaction for hypertension when evaluating the relationship between TyG-BMI and the primary endpoint and for age, hypertension, and maximum wall thickness when assessing the association with all-cause death. “However, this finding should be interpreted cautiously because the number of events in some strata was limited,” the researchers noted. Study limitations include the retrospective design, which introduces the potential for selection bias and residual confounding; the lack of systematic collection of baseline medication data; the use of only preoperative baseline TyG-BMI values, precluding an assessment of changes in metabolic status over time; and the lack of information on indices reflective of central adiposity. “Our study highlighted the potential relevance of TyG-BMI for preoperative risk assessment and postoperative metabolic management in HOCM. The elevation in the TyG-BMI corresponded to worse clinical outcomes,” the study authors said. “Given its significant relationship with clinical outcomes, TyG-BMI may serve as an accessible adjunctive marker of metabolic risk, but its clinical utility requires external validation,” they concluded. References: Song C, Zheng X, Cui J, et al. Association between triglyceride glucose – body mass index and clinical outcomes after septal myectomy. Front Endocrinol (Lausanne). Published online July 30, 2026. doi:10.3389/fendo.2026.1855510