The triglyceride-glucose index is inversely associated with atrial fibrillation in patients with hypertrophic cardiomyopathy: evidence from a cross-sectional study

Background: The triglyceride-glucose (TyG) index is highly correlated with cardiovascular diseases, but the relationship between TyG index changes and hypertrophic cardiomyopathy (HCM) has rarely been reported. We aimed to investigate whether the level and the change of the TyG index were associated with HCM. Methods: The study retrospectively collected socio-demographic, medical, anthropometric, and laboratory data from patients with HCM who were continuously admitted to Beijing Anzhen Hospital between January 1, 2018, and December 31, 2022. Logistic regressions were used to determine the relationship between the TyG index, other HCM factors, and the incidence of atrial fibrillation (AF). After stratifying patients by TyG index, we compared inter-group characteristics and evaluated the association between the TyG index and AF using logistic regression, followed by subgroup analyses to examine the consistency of this association. Results: For the total HCM population, the prevalence of AF was 285/1284(22.20%). Patients with AF had greater age (61.8 ± 10.6 vs. 54.0 ± 14.2 years, P < 0.001), lower body mass index (BMI) (25.59 ± 3.27 vs. 26.47 ± 4.03, P < 0.001), larger left atrial diameter (LAD) (46.86 ± 7.11 vs. 40.39 ± 5.98, P < 0.001), and more moderate or severe mitral regurgitation (MR) (82.5% vs. 67.0%, P < 0.001). Patients with AF had significantly greater free fatty acids (FFA) level (0.50 ± 0.26 vs. 0.44 ± 0.22, P = 0.004), although their triglycerides (TG) (1.45 ± 0.95 vs. 1.77 ± 1.05, P < 0.001), TyG index (8.64 ± 0.64 VS. 8.84 ± 0.64, P < 0.001), total cholesterol (TC) (4.21 ± 1.07 vs. 4.53 ± 1.07, P < 0.001), and low-density lipoprotein cholesterol (LDL-C) (2.55 ± 0.91 vs. 2.75 ± 0.88, P = 0.001) levels were much lower. In the multivariate logistic regression model, we discovered that age, LAD, left ventricular ejection fraction (LVEF), and TyG index were independently linked with the occurrence of AF. Subgroup analysis of the study population showed no interaction between all subgroups after adjusting for confounders. Conclusion: In conclusion, our study demonstrates that a higher TyG index is inversely associated with key adverse features in HCM, including LAD, and the prevalence of AF and moderate-to-severe MR. Further investigations are warranted to elucidate the mechanisms underlying these associations and their impact on the long-term prognosis of HCM.