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September 14, 2026Frontiers in EndocrinologyOpen Access

Triglyceride–glucose index as a metabolic risk marker for adverse outcomes after coronary artery bypass grafting: a systematic review and meta-analysis

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Why the study?

Does a higher triglyceride-glucose index predict major adverse cardiovascular events in patients undergoing coronary artery bypass grafting?

Population

5,978 patients undergoing coronary artery bypass grafting (CABG) from 6 retrospective cohort reports

Comparison

Higher triglyceride-glucose index vs Lower TyG index (lowest tertile)

Design

Meta-analysis

Key result

Each 1-unit increase in the triglyceride-glucose index was associated with a 62.4% higher hazard of major adverse cardiovascular events (HR 1.624) following coronary artery bypass grafting.

Authors

YZYuhan ZhangYZYifan ZengYNYirui Ning

Discussion

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Overview

May aid post-CABG risk stratification as a metabolic marker; extends observational evidence on TyG prognostic value.

Key Points

  • To assess the prognostic utility of the triglyceride–glucose (TyG) index, an established surrogate marker for insulin resistance, in predicting adverse cardiovascular outcomes in patients undergoing coronary artery bypass grafting (CABG).
  • Conducted a PRISMA-compliant systematic review and meta-analysis across four medical databases through July 10, 2026 (PROSPERO CRD420251158075).
  • Included six retrospective cohort reports comprising 5,978 participants across four independent cohort families, including two multicenter cohorts.
  • Extracted multivariable-adjusted hazard ratios (HRs) and crude odds ratios (ORs) for major adverse cardiovascular events (MACE) evaluated by 1-unit TyG increases and tertiles.
  • Each 1-unit increase in the TyG index was associated with a 62.4% higher hazard of MACE (HR: 1.624, 95% CI: 1.349–1.955).
  • Patients in the highest TyG tertile experienced more than double the hazard of MACE compared to the lowest tertile (HR: 2.093, 95% CI: 1.635–2.680; crude OR: 2.59, 95% CI: 1.97–3.40).
  • Higher TyG values significantly correlated with elevated risks of all-cause mortality, nonfatal stroke, and nonfatal myocardial infarction, but showed no association with repeat revascularization.

Study Design

Type

Meta-Analysis (n=5,978)

Structured PICO

Does a higher triglyceride-glucose index predict major adverse cardiovascular events in patients undergoing coronary artery bypass grafting?

P
Population
5,978 adult patients undergoing coronary artery bypass grafting across 6 retrospective cohorts in China, followed for 24 to 85 months to evaluate the prognostic value of the triglyceride-glucose index.
E
Exposure
Higher triglyceride-glucose (TyG) index (evaluated per 1-unit increase and by tertiles)
C
Comparator
Lower TyG index (lowest tertile)
O
Outcome
Major adverse cardiovascular events (MACE)composite

Main Result

Hazard Ratio: 1.624 (95% CI 1.349–1.955)

p-value: p=<0.001

The triglyceride-glucose index may serve as an accessible supplementary metabolic risk marker for predicting major adverse cardiovascular events following coronary artery bypass grafting.

Limitations

  • Only six retrospective cohort reports from China were included, limiting geographic diversity and generalizability.
  • Differences in study population selection, MACE definitions, follow-up duration, and covariate adjustment strategies exacerbated heterogeneity.
  • Inadequate reporting of drug exposure, fasting status, timing of sampling, and perioperative blood glucose management.
  • Limited number of independent cohorts restricted the precision of pooled estimates and subgroup comparisons.
  • Included studies were retrospective cohort reports
  • Further prospective validation is required before routine application

Cite This Study

Zhang et al. (2026) conducted a meta-analysis in Coronary artery disease undergoing coronary artery bypass grafting (CABG) (n=5,978). Triglyceride-glucose (TyG) index vs. Lower TyG index was evaluated on Major adverse cardiovascular events (MACE) (HR 1.624, 95% CI 1.349-1.955, p=<0.001). Each 1-unit increase in the triglyceride-glucose index was associated with a 62.4% higher hazard of major adverse cardiovascular events (HR 1.624) following coronary artery bypass grafting.

synapsesocial.com/papers/6aa7afef79e9260bc85aac67https://doi.org/10.3389/fendo.2026.1909829
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