Triglyceride-glucose index and prognosis in individuals afflicted with heart failure and chronic kidney disease. ESC heart failure BACKGROUND:The triglyceride-glucose (TyG) index has demonstrated correlations with adverse clinical outcomes in patients with ischaemic stroke, coronary heart disease and cardiac failure. However, its association with overall mortality in individuals concurrently experiencing heart failure (HF) and chronic kidney disease (CKD) remains inadequately explored. METHODS:Utilizing the Medical Information Mart for Intensive Care IV (Version 2.2) repository, subjects underwent quartile stratification based on the TyG index. The primary endpoint was all-cause mortality during hospitalization. Cox proportional hazard models were employed to examine the correlation between TyG and all-cause mortality in HF patients with CKD. Evaluation involved Kaplan-Meier (KM) analysis and restricted cubic splines (RCSs) to compare mortality rates during hospitalization and 1 year after admission across cohorts with varying TyG index levels. RESULTS:A cohort of 1537 HF and CKD patients participated. Cox regression analysis revealed elevated TyG levels as an independent risk factor for both in-hospital and 1 year mortality. RCS analysis indicated a rising, non-linear association between TyG levels and all-cause mortality (P value for non-linear <0.001). KM survival curves demonstrated a statistically significant reduction in survival rates within the high TyG index group compared with the low one (log-rank P < 0.001). CONCLUSIONS:The TyG index exhibited substantial independent prognostic value for elevated in-hospital and 1 year all-cause mortality among the cohort with HF and CKD. These findings suggest that assessing the TyG index could play a crucial role in developing novel therapeutic strategies to improve outcomes for this high-risk demographic. 10.1002/ehf2.14898