{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T17:42:19Z","timestamp":1781286139688,"version":"3.54.1"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The role of the triglyceride-glucose (TyG) index in critically ill patients with congestive heart failure (CHF) and atrial fibrillation (AF), requiring intensive care unit (ICU) admission, remains unclear. This study aimed to investigate the association between the TyG index and the clinical prognosis of critically ill patients with CHF and AF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective observational cohort study utilized data from the Medical Information Mart for Intensive Care-IV (MIMIC IV2.2) database. Participants were categorized into four groups based on TyG index level. The primary outcome was hospital all-cause mortality. Multivariable logistic proportional regression analysis and restricted cubic spline regression were employed to assess the TyG index's association with hospital mortality in patients with CHF and AF. Sensitivity analysis included determining the TyG index's feature importance through subgroup analysis in different subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 787 patients were included in the study, with hospital and ICU mortalities of 14.2% and 8.3%, respectively. Multivariate logistic regression analysis demonstrated that the TyG index was independently associated with an increased risk of hospital mortality (odds ratio (OR), 1.59 [95% confidence interval (CI) 1.15\u20132.19], <jats:italic>P<\/jats:italic>\u2009=\u20090.005) and ICU mortality [OR 1.9; (95% CI 1.28\u20132.83), <jats:italic>P<\/jats:italic>\u2009=\u20090.001] after adjusting for confounders. The restricted cubic spline regression model indicated a linear increase in the risks of in-hospital and ICU mortality with a higher TyG index. Sensitivity analysis revealed consistent effect sizes and directions in different subgroups, ensuring result stability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results of our study suggest a significant association between the TyG index and hospital and ICU all-cause mortality in critically ill patients with CHF and AF. This finding implies that the TyG index could potentially serve as a valuable tool for identifying patients with CHF and AF at an elevated risk of all-cause mortality.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1476815","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T05:19:34Z","timestamp":1743657574000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Association between triglyceride-glucose index and all-cause mortality in patients with congestive heart failure and atrial fibrillation"],"prefix":"10.3389","volume":"12","author":[{"given":"Fuqiang","family":"Kan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zewen","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donglai","family":"Bao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingliang","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ningning","family":"Ji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"100691","DOI":"10.1016\/j.cpcardiol.2020.100691","article-title":"Physiopathology and diagnosis of congestive heart failure: consolidated certainties and new perspectives","volume":"46","author":"Franca","year":"2020","journal-title":"Curr Probl Cardiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1002\/cpt.913","article-title":"Emerging therapies for congestive heart failure","volume":"103","author":"Povsic","year":"2018","journal-title":"Clin Pharmacol Ther"},{"key":"B3","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.cardfail.2011.09.003","article-title":"Patient characteristics from a regional multicenter database of acute decompensated heart failure in Asia Pacific (ADHERE International-Asia Pacific)","volume":"18","author":"Atherton","year":"2012","journal-title":"Card Fail."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1242","DOI":"10.1002\/ejhf.890","article-title":"Clinical phenotypes and outcome of patients hospitalized for acute heart failure: the ESC heart failure long-term registry","volume":"19","author":"Chioncel","year":"2017","journal-title":"Eur J Heart Fail."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2811","DOI":"10.1253\/circj.CJ-17-1386","article-title":"Demographics, management, and in-hospital outcome of hospitalized acute heart failure syndrome patients in contemporary real clinical practice in Japan- observations from the prospective, multicenter Kyoto congestive heart failure (KCHF) registry","volume":"82","author":"Yaku","year":"2018","journal-title":"Circ J"},{"key":"B6","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1016\/j.jacc.2023.12.033","article-title":"Implications of atrial fibrillation for guideline-directed therapy in patients with heart failure: JACC state-of-the-art review","volume":"83","author":"Newman","year":"2024","journal-title":"J Am Coll Cardiol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1002\/ejhf.1531","article-title":"Clinical practice update on heart failure 2019: pharmacotherapy, procedures, devices and patient management. 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