This study investigates the relationship between triglyceride-glucose (TyG) index trajectories and the results of ablation in patients with stage 3D atrial fibrillation (AF). A retrospective cohort study was carried out on patients who underwent AF Radiofrequency Catheter Ablation (RFCA) at the Cardiology Department of the Fourth Affiliated Hospital of Zhejiang University and Taizhou Hospital of Zhejiang Province from January 2016 to December 2022. The main clinical endpoint was determined as the occurrence of atrial arrhythmia for at least 30 s following a 3-month period after ablation. Using a latent class trajectory model, different trajectory groups were identified based on TyG levels. The relationship between TyG trajectory and the outcome of AF recurrence in patients was assessed through Kaplan-Meier survival curve analysis and multivariable Cox proportional hazards regression model. The study included 997 participants, with an average age of 63.21 ± 9.84 years, of whom 630 were males (63.19%). The mean follow-up period for the participants was 30.43 ± 17.75 months, during which 200 individuals experienced AF recurrence. Utilizing the minimum Bayesian Information Criterion (BIC) and the maximum Entropy principle, TyG levels post-AF RFCA were divided into three groups: Locus 1 low-low group (n = 791), Locus 2 low-high-low group (n = 14), and Locus 3 high-high group (n = 192). Significant differences in survival rates among the different trajectories were observed through the Kaplan-Meier curve (P < 0.001). Multivariate Cox regression analysis showed a significant association between baseline TyG level and AF recurrence outcomes (HR = 1.255, 95% CI: 1.087–1.448). Patients with TyG levels above 9.37 had a higher risk of adverse outcomes compared to those with levels below 8.67 (HR = 2.056, 95% CI: 1.335–3.166). Furthermore, individuals in Locus 3 had a higher incidence of outcomes compared to those in Locus 1 (HR = 1.580, 95% CI: 1.146-2). The TyG trajectories in patients with stage 3D AF are significantly linked to the outcomes of AF recurrence. Continuous monitoring of TyG levels during follow-up may help in identifying patients at high risk of AF recurrence, enabling the early application of effective interventions.

中文翻译：

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3D 期心房颤动患者甘油三酯-葡萄糖指数轨迹与射频消融结果之间的关联

本研究探讨了 3D 期心房颤动 (AF) 患者甘油三酯-葡萄糖 (TyG) 指数轨迹与消融结果之间的关系。对2016年1月至2022年12月在浙江大学第四附属医院心内科和浙江省台州医院接受房颤射频导管消融术（RFCA）的患者进行回顾性队列研究。主要临床终点确定为消融后 3 个月内发生房性心律失常至少 30 秒。使用潜在类别轨迹模型，根据 TyG 水平识别不同的轨迹组。通过Kaplan-Meier生存曲线分析和多变量Cox比例风险回归模型评估TyG轨迹与患者AF复发结果之间的关系。该研究包括 997 名参与者，平均年龄为 63.21 ± 9.84 岁，其中 630 名是男性（63.19%）。参与者的平均随访时间为 30.43 ± 17.75 个月，在此期间有 200 人经历了 AF 复发。利用最小贝叶斯信息准则 (BIC) 和最大熵原理，AF RFCA 后的 TyG 水平分为三组：轨迹 1 低-低组 (n = 791)、轨迹 2 低-高-低组 (n = 14) 和轨迹 3 高-高组 (n = 192)。通过 Kaplan-Meier 曲线观察到不同轨迹之间的生存率存在显着差异（P < 0.001）。多变量 Cox 回归分析显示基线 TyG 水平与 AF 复发结果之间存在显着相关性（HR = 1.255，95% CI：1.087–1.448）。与 TyG 水平低于 8.67 的患者相比，TyG 水平高于 9.37 的患者出现不良后果的风险更高（HR = 2.056，95% CI：1.335-3.166）。此外，与基因座 1 中的个体相比，基因座 3 中的个体的结果发生率更高（HR = 1.580，95% CI：1.146-2）。 3D 期 AF 患者的 TyG 轨迹与 AF 复发的结果显着相关。在随访期间持续监测 TyG 水平可能有助于识别房颤复发高风险的患者，从而能够及早应用有效的干预措施。