Pre-Operative Triglyceride-Glucose Index in the Prediction of One-Year Mortality after isolated Coronary-Artery By-Pass Grafting (CABG) Surgery

BACKGROUND Insulin resistance (IR) is a key contributor to poor cardiovascular outcomes following surgery but remains underrepresented in conventional cardiac risk models. The triglyceride-glucose index (TGI), a surrogate marker of IR, has emerged as a promising metabolic risk indicator. OBJECTIVE To evaluate the prognostic value of preoperative TGI in predicting 1-year mortality among patients undergoing isolated coronary artery bypass grafting (CABG). METHODS In this single-center retrospective cohort study, 705 adult patients who underwent isolated CABG between January 2022 and December 2023 were analyzed. TGI was calculated as ln(fasting triglyceride × fasting glucose)/2. Patients were stratified based on median TGI values. Multivariable logistic regression was performed to identify independent predictors of 1-year mortality, adjusting for age, gender, and diabetes mellitus. RESULTS The cohort had a median age of 62 years; 21.3% were female. Diabetes and hypertension were present in 49.9% and 58.3% of patients, respectively. Higher TGI levels were observed in patients who died within 1 year (P = .016). TGI independently predicted 1-year mortality (odds ratio: 4.304; 95% CI: 1.30-14.24; P = .018). Elevated TGI was also associated with increased incidence of acute kidney injury (P = .011), longer intensive care unit stays, and prolonged intubation times (both P < .05). CONCLUSION Preoperative TGI is an independent predictor of 1-year mortality after CABG and may enhance current risk stratification tools. Integrating TGI into preoperative assessment could guide individualized perioperative management, particularly in metabolically high-risk patients. Prospective studies are warranted to validate these findings and evaluate the impact of TGI-based interventions.