The Triglyceride-glucose index (TyGi) is a novel surrogate marker for insulin resistance and has been implicated in many cardiovascular diseases. However, there is a lack of pooled data on the impact of TyGi on post-complex percutaneous coronary intervention (PCI) outcomes. We conducted a systematic review (SR) and meta-analysis (MA) to study the relationship between TyGi and outcomes of complex PCI. PubMed, SCOPUS and Google Scholar were comprehensively searched till January 7, 2024, for studies reporting TyGi and post-complex PCI outcomes. We assessed the random effects model, leave-one-out sensitivity analysis for pooled odds, and heterogeneity with I2 statistics. P < 0.05 was considered significant. Six studies (two prospective and four retrospective), with a total of 14,393 patients, were included in our study. Our cohort had a mean age of 59.60±6.03 years and was predominantly male (80%). The median follow-up duration was 36.6 months. Four studies grouped patients into tertiles (T1, T2, T3) based on TyGi levels. T2 and T3 groups showed significantly higher odds of MACCE (all-cause mortality, non-fatal myocardial infarction, non-fatal stroke) compared to the T1 group (T3: aHR 1.91, 95% CI 1.41-2.60; T2: aHR 1.39, 95% CI 1.11-1.73; all p<0.01). Two studies grouped patients into higher vs. lower TyGi values and demonstrated higher odds of MACCE with higher vs. lower TyGi levels (aHR 1.65, 95% CI 1.29-2.10, p<0.01). (Fig 1). Our extensive study of 14,393 patients showed a positive association with higher TyGi values and MACCE in patients post-complex PCI. Prospective studies must be conducted to validate these results.
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