{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:01:31Z","timestamp":1787018491426,"version":"build-2736575974"},"reference-count":33,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"CAMS Innovation Fund for Medical Sciences","award":["2021I2M1\u2013008"],"award-info":[{"award-number":["2021I2M1\u2013008"]}]},{"name":"Beijing Clinical Key Specialized Projects","award":["PM202401220002"],"award-info":[{"award-number":["PM202401220002"]}]},{"name":"National High Level Hospital Clinical Research","award":["2022GSPQN06"],"award-info":[{"award-number":["2022GSPQN06"]}]},{"name":"National High Level Hospital Clinical Research","award":["2023GSPGG02"],"award-info":[{"award-number":["2023GSPGG02"]}]},{"name":"National High Level Hospital Clinical Research","award":["2023GSPQN17"],"award-info":[{"award-number":["2023GSPQN17"]}]},{"name":"National High Level Hospital Clinical Research","award":["2023GSPQN34"],"award-info":[{"award-number":["2023GSPQN34"]}]},{"name":"National High Level Hospital Clinical Research","award":["2023GSPRC05"],"award-info":[{"award-number":["2023GSPRC05"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Angiology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>\n                    This prospective cohort study evaluated the prognostic value of the triglyceride-glucose (TyG) index and its metabolic mediation pathways in 16\u2009499 patients with complex coronary lesions (American College of Cardiology\/American Heart Association type B2\/C) undergoing percutaneous coronary intervention (PCI). Over a median 3-year follow-up, 535 patients (3.2%) experienced cardiovascular (CV) events. Patients in the highest TyG tertile (T3: &gt;9.10) demonstrated a 2.442-fold increased CV risk compared with the lowest tertile (T1: &lt;8.63; 95% CI 1.923-3.102,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.001), with a significant dose-response relationship (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    -trend\u2009&lt;\u2009.001). Structural equation modeling revealed that metabolic burden (hypertension, dyslipidemia, type 2 diabetes mellitus) mediated 50.0% of TyG-associated risk (indirect effect\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.038). TyG index exhibited superior predictive accuracy for CV events compared with the TG\/HDL-C ratio (area under the curve [AUC] 0.617 vs 0.577,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.004), though their combination did not significantly improve discrimination over TyG alone (\u25b3AUC\u2009=\u20090.001,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.694). Type 2 diabetes mellitus accounted for 62.3% of the mediation effect, surpassing hypertension (20.8%), and dyslipidemia (16.9%). These findings establish the TyG index as an independent predictor of CV outcomes in complex coronary lesions, with metabolic comorbidities explaining half its prognostic impact. Integration of TyG-driven metabolic phenotyping may optimize risk stratification and targeted interventions in high-risk PCI populations.\n                  <\/jats:p>","DOI":"10.1177\/00033197251390139","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T08:45:01Z","timestamp":1763455501000},"page":"1051-1061","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Triglyceride-Glucose Index Mediated by Metabolic Burden Predicts Cardiovascular Events in Patients With Complex Coronary Lesions: A Prospective Cohort Study"],"prefix":"10.1177","volume":"77","author":[{"given":"Zhihao","family":"Zheng","sequence":"first","affiliation":[{"name":"Cardiometabolic Medicine Center, Department of Cardiology, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China"},{"name":"State Key Laboratory of 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Shi","sequence":"additional","affiliation":[{"name":"Cardiometabolic Medicine Center, Department of Cardiology, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China"},{"name":"State Key Laboratory of Cardiovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Yang","sequence":"additional","affiliation":[{"name":"Cardiometabolic Medicine Center, Department of Cardiology, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China"},{"name":"State Key Laboratory of Cardiovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenxi","family":"Song","sequence":"additional","affiliation":[{"name":"Cardiometabolic Medicine 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