目的：探索甘油三酯-葡萄糖（triglyceride-glucose, TyG）指数与心房颤动（atrial fibrillation, AF）患者发生急性心肌梗死（acute myocardial infarction, AMI）的关系。方法：纳入首都医科大学附属北京同仁医院和首都医科大学附属北京友谊医院4 277例住院的AF患者，根据是否因AMI入院分为未发生AMI组[AMI(−)，3 725例]和发生AMI组[AMI(+), 552例]。采用Logistic回归评估TyG指数与AMI的关系，并根据基线是否存在糖尿病进行亚组分析。结果：在AF患者中，AMI(+)组的TyG指数显著高于AMI(−)组（8.83±0.73比8.56±0.66, P < 0.001），AMI(+)组患者年龄更大、合并症更多（均P < 0.05）。多因素Logistic回归结果显示，高TyG指数是AF患者发生AMI的独立危险因素[优势比（odds ratio, OR)=1.824, 95%CI 1.540~2.161, P < 0.001]，TyG指数预测AMI的受试者操作特征（receiver operating characteristic, ROC）曲线下面积为0.614（95%CI 0.589~0.640, P < 0.001），截断值为8.79。在AF患者中，无论是否存在糖尿病，TyG指数均与AMI发生风险呈正相关。结论：TyG指数与AF患者发生AMI的风险呈正相关，且不受糖尿病状态的影响。

Objective To explore the relationship between triglyceride-glucose (TyG) index and the occurrence of acute myocardial infarction (AMI) in patients with atrial fibrillation (AF). Methods A total of 4 277 hospitalized AF patients from Beijing Tongren Hospital and Beijing Friendship Hospital affiliated to Capital Medical University were enrolled. They were divided into a non-AMI group [AMI(−), 3 725 cases] and an AMI group [AMI(+), 552 cases] based on whether they were admitted for AMI. Logistic regression was used to assess the association between the TyG index and AMI, and subgroup analyses were performed according to the presence of diabetes at baseline. Results Among AF patients, the TyG index was significantly higher in the AMI(+) group than in the AMI(−) group (8.83 ± 0.73 vs. 8.56 ± 0.66, P < 0.001). Additionally, patients in the AMI(+) group were older and had more comorbidities (both P < 0.05). Multivariate Logistic regression showed that high TyG index was an independent risk factor for AMI in AF patients [odds ratio(OR) = 1.824, 95%CI 1.540−2.161, P < 0.001], and the area under the receiver operating characteristic (ROC) curve for the TyG index in predicting AMI was 0.614 (95%CI 0.589−0.640, P < 0.001), with a cut-off value of 8.79. In AF patients, the TyG index was positively associated with the risk of AMI regardless of the presence of diabetes. Conclusions The TyG index is positively associated with the risk of AMI in AF patients, which is not affected by diabetes status.