A recent study published in Cardiovascular Diabetology demonstrated the predictive accuracy of the triglyceride-glucose (TyG) index combined with body mass index (BMI) (TyG-BMI index) in predicting mortality among elderly patients with severe heart failure (HF) and type 2 diabetes mellitus (T2DM).

The triglyceride-glucose (TyG) index is an indicator of cardiovascular outcomes and insulin resistance (IR). However, there is limited knowledge about the prognostic utility of the TyG-BMI index in elderly patients with T2DM and heart failure. The study aimed to assess how the TyG-BMI index correlates with all-cause mortality at different time points in this group. Researchers conducted a retrospective cohort study analyzing patients aged over 65 years with severe HF and T2DM (n=4,523). TyG-BMI was measured at ICU admission, and participants were stratified into four groups (quartiles Q1–Q4) based on this. All-cause mortality at days 60, 90, 180, and 365 was the primary outcome.

Results revealed a graded reduction in mortality with increasing TyG-BMI quartiles. Higher mortality at 90 days (58.70% vs. 48.45%) and 365 days (80.54% vs. 73.91%) was observed in patients with the lowest TyG-BMI (Q1) compared to Q4. The lower mortality risk with Q4 was confirmed by adjusted Cox models (365-day HR for Q4 vs. Q1: 0.74). Across all subgroups (age, cardiac function, comorbidities), higher TyG-BMI was associated with reduced mortality. This association was more pronounced in patients without prior myocardial infarction (365-day aHR 0.69 vs. 0.81 with infarction) and in patients with HFrEF (LVEF ≤40%; all-time point HR >1).

The thresholds for TyG-BMI for predicting 60-day mortality were 148.73 and 163.38 for 365-day mortality. A greater reduction in mortality was observed with each 1-unit increase in TyG-BMI below this threshold. However, above the threshold, no positive effect was observed.