Data Sheet 1_Incremental value of insulin resistance surrogate indices beyond the CHA2DS2-VASc score for predicting thromboembolic events in patients with chronic heart failure and atrial fibrillation.pdf

After multivariable adjustment, the hazard ratios per 1-SD increase were 1.27 (95% confidence interval, 1.13–1.43) for the TyG index, 1.41 (1.28–1.56) for the TyG-BMI index, 1.27 (1.20–1.34) for METS-IR, and 1.13 (1.08–1.19) for the TG/HDL-C ratio (all P < 0.001). Risk increased progressively across tertiles of each index, and the associations remained consistent in competing-risk analyses. Adding METS-IR or the TyG-BMI index to the CHA₂DS₂-VASc score significantly increased the AUC from 0.637 to 0.682 and 0.673, respectively, and improved reclassification.

Decision curve analysis showed greater net benefit for models incorporating IR surrogate indices, particularly METS-IR and the TyG-BMI index. The incremental predictive improvements appeared more evident in patients with non-paroxysmal AF.</p>Conclusions<p>IR surrogate indices were independently associated with IS/SE in patients with CHF and AF. METS-IR and the TyG-BMI index provided the most consistent incremental information beyond the CHA₂DS₂-VASc score, with more evident improvements observed in patients with non-paroxysmal AF.</p>