Baseline TyG index, myoglobin, and cerebral infarction history predict the onset of pulmonary hypertension in coronary artery disease patients after PCI treatment within a median of 4.5 years: a prospective cohort study

Aim To identify the predictive role of the TyG index for the onset of pulmonary hypertension in patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI) treatment. Methods We performed this prospective cohort study among CAD patients who received PCI treatment in our center from July 2016 to October 2022. The baselines of echocardiography at both cross-sections and blood biomarkers. A coronary angiography operation was also performed. Within a median of 4.5 years of follow-up, the patients underwent echocardiography to measure their pulmonary hypertension (PH). Results Baseline BNP was statistically higher in the PH patients (p = 0.007). The baseline myoglobin (MYO), was significantly higher among PH patients (p < 0.001). Though the glucose level showed no difference between PH and non-PH groups, the HDL-C was in a lower level in the PH group (p = 0.033). However, TyG index showed no differences between PH and non-PH groups [6.95 (6.47-7.36) vs. 7.15 (6.49-7.96), p = 0.202]. In the univariate regression, cerebral infarction history, right atria end-diastolic internal diameter, MYO, triglyceride, HDL-C and TyG index (p < 0.05) were potential predictors for PH. Finally, the adjusted logistic regression indicated that cerebral infarction history (p = 0.39), MYO (p = 0.044) and TyG index (p = 0.048) were independent predictors of the onset of PH. Conclusion PH is prevalent in CAD patients after PCI treatment. The baseline TyG index, cerebral infarction history, and MYO level were independent predictors for PH in CAD patients after PCI treatment. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was supported by the Senior Medical Talents Program of Chongqing for Yong and Middle-aged, the Excellent Scientist Pool Program of Army Medical University ("Miaopu Program 2019R046") and Basic Research Program from Army Military Medical University (2020D050). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Our study conforms to the Declaration of Helsinki. The study has been approved by our ethical committee of Xinqiao Hospital, Third Military Medical University (Army Military Medical University). The patients were familiarized with the procedure and contents of the study and provided written informed consent. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Not Applicable The data were available from the corresponding authors. * AF : arial fibrillation ACEI : angiotensin converting enzyme inhibitor ARB : angiotensin receptor blocker BNP : B-type natriuretic peptide BUN : urea nitrogen concentration CAD : coronary artery disease CAG : coronary angiography Ca2+ : serum calcium concentration CCB : calcium channel blockers CI : Confidence interval CK-MB : Creatine kinase-MB Cl− : chloride ion Cr : concentration of plasma creatinine DBP : diastolic blood pressure FBG : fasting blood glucose FS : fractional shortening HDL-C : high-density lipoprotein cholesterol HR : heart rate IR : insulin resistance K+ : serum potassium concentration LAD : end-diastolic internal diameter of the left atria LDL-C : low-density lipoprotein cholesterol LVDD : end-diastolic internal diameter of left ventricle LVEF : ejection fraction of left ventricle LVPW : left ventricular posterior wall MACE : major adverse cardiovascular events MACCE : major adverse cardiac and cerebrovascular events MYO : myoglobin Na+ : sodium concentration OR : odds ratio P : phosphate concpentration PAP : pulmonary arterial pressure PH : pulmonary hypertension PCI : percutaneous coronary intervention RAD : end-diastolic internal diameter of right atria RVD : end-diastolic internal diameter of right ventricle SBP : systolic blood pressure STEMI : ST elevation myocardial infarction T2DM : diabetes mellitus type 2 TG : triglyceride TNI : Troponin TR : tricuspid regurgitation TRA : TR area TRV : TR velocity TyG index : triglyceride-glucose index