Objective  To explore the relationship between baseline serum triglyceride-glucose （TyG） index and primary cardiovascular event （CVE） in nondiabetic peritoneal dialysis （PD） patients.

Methods  From January 2014 to June 2020, 119 nondiabetic patients undergoing PD catheterization with regular postoperative dialysis and follow-ups were enrolled. According to the median baseline TyG index, they were assigned into two groups of low TyG （TyG＜8.47） and high TyG （TyG≥8.47）. During a median follow-up period of 36（5-95） months, primary CVE was recorded.

Results  Female （37 vs 21）, body mass index （BMI） （22.54 ± 3.50） kg/m² vs （21.29 ± 3.04） kg/m², albumin （35.7 ± 5.8） g/L vs （33.0 ± 5.8） g/L, triacylglycerol 1.55（1.32, 1.98） mmol/L vs 0.90（0.73, 1.03） mmol/L and fasting plasma glucose 4.97（4.58, 5.47） mmol/L vs 4.49（4.19, 4.95） mmol/L were significantly higher in high TyG group than those in low TyG group （all P＜0.05）. Spearman’s correlation analysis indicated that TyG index was correlated positively with BMI and albumin （all P＜0.05）. And 13 patients （22.03%） in low TyG group and 27 （45%） in high TyG group developed primary CVE during follow-ups. Kaplan-Meier analysis revealed that high TyG group had a significantly higher incidence of primary CVE than low TyG group （χ² = 4.858, P = 0.028）. Multivariate Cox regression analysis indicated that TyG≥8.47 （HR = 2.418, 95%CI: 1.105-5.294, P = 0.027） was an independent risk factor for an initial occurrence of primary CVE while total cholesterol （HR = 1.686, 95%CI: 1.133-2.509, P = 0.010） an independent influencing factor for the occurrence of primary CVE.

Conclusions  High baseline TyG index （TyG≥8.47） is an independent risk factor for the occurrence of primary CVE. Early intervention may lower the risk of developing a primary CVE in PD patients with a high baseline TyG index.