Triglyceride-glucose index as a novel predictor of major adverse cardiovascular events in patients with coronary revascularization: a meta-analysis of cohort studies

TL;DR

This study finds that the triglyceride-glucose index (TyG) is a strong predictor of major cardiovascular events in patients who have undergone coronary revascularization.

Contribution

The study demonstrates that TyG is a novel and effective predictor of adverse cardiovascular outcomes in revascularized patients.

Findings

High TyG index is associated with increased risk of major adverse cardiovascular events (MACEs) in coronary revascularization patients.

Subgroup analysis shows higher MACE risk in both CABG and PCI groups with elevated TyG index.

TyG index is also linked to higher risks of mortality, myocardial infarction, stroke, and repeat revascularization.

Abstract

The triglyceride-glucose index (TyG) has gained attention as an alternative indicator for assessing insulin resistance (IR). The purpose of this study was to comprehensively summarize the correlation between the TyG index and cardiovascular events in patients with coronary revascularization.

PubMed, Web of Science, Embase, and The Cochrane Library databases were searched to find relevant literature on the prognostic assessment of TyG index in patients undergoing coronary artery revascularization. Utilize the risk ratio (RR) and its 95% confidence interval (CI) as the standard for assessing the correlation between TyG and major adverse cardiovascular events (MACEs) in patients undergoing coronary artery revascularization. Conduct sensitivity analysis and subgroup analysis to detect the sources of heterogeneity and assess the stability of the results.

A total of 12 studies involving 9,973 participants were included. The results of the study indicate that a high TyG index was related to the major adverse cardiovascular event in patients undergoing coronary artery revascularization (RR:2.0,95%CI: 1.71–2.35, I2=76.2%, p < 0.0001). Subgroup analysis reveals that the probability of MACEs occurring in patients with high TyG index is higher than in those with low TyG index after two different coronary artery revascularization procedures: CABG group (RR:2.10, 95%CI:1.80–2.45, I2 = 20.9%, p = 0.0001). PCI group: (RR:1.94, 95%CI:1.54–2.46, I2 = 84.2%, p < 0.00001). Additionally, we also demonstrated the prognostic value of the TyG index in all-cause mortality(p = 0.003), non-fatal myocardial infarction(p = 0.003), non-fatal stroke(p < 0.0001) and repeat revascularization(p < 0.0001).

Higher TyG index may be independently associated with higher incidence of MACEs in patients with coronary revascularization.

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