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

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.

甘油三酯-葡萄糖指数（triglyceride-glucose index, TyG）作为评估胰岛素抵抗（insulin resistance, IR）的替代指标已受到学界广泛关注。本研究旨在全面总结TyG指数与接受冠状动脉血运重建术患者的心血管事件相关性。
检索PubMed、Web of Science、Embase及Cochrane图书馆数据库，查找有关TyG指数对冠状动脉血运重建术后患者预后评估的相关文献。以风险比（risk ratio, RR）及其95%置信区间（confidence interval, CI）作为评估TyG指数与冠状动脉血运重建术后患者主要不良心血管事件（major adverse cardiovascular events, MACEs）相关性的效应指标。开展敏感性分析与亚组分析，以明确异质性来源并评估研究结果的稳定性。
最终共纳入12项研究，涉及9973名受试者。研究结果显示，高TyG指数与冠状动脉血运重建术后患者的主要不良心血管事件显著相关（RR=2.0，95%CI：1.71~2.35，I²=76.2%，P<0.0001）。亚组分析表明，在两种不同冠状动脉血运重建术式中，高TyG指数患者发生主要不良心血管事件的风险均高于低TyG指数患者：冠状动脉旁路移植术（coronary artery bypass grafting, CABG）组（RR=2.10，95%CI：1.80~2.45，I²=20.9%，P=0.0001）；经皮冠状动脉介入治疗（percutaneous coronary intervention, PCI）组（RR=1.94，95%CI：1.54~2.46，I²=84.2%，P<0.00001）。此外，本研究还证实了TyG指数在全因死亡率（P=0.003）、非致命性心肌梗死（P=0.003）、非致命性卒中（P<0.0001）及再次血运重建（P<0.0001）中的预后价值。
高TyG指数可能与冠状动脉血运重建术后患者更高的主要不良心血管事件发生率独立相关。