Abstract WP369: Triglyceride-Glucose Index; a Novel Predictor of Stroke and Cardiovascular Events in Patients with Myocardial Infarction: a Systematic Review and Meta-analysis

Background: The Triglyceride-Glucose (TyG) index has recently come under study as a reliable, inexpensive marker of insulin resistance. It is garnering attention as a potential tool for prognostication in cardiovascular disease. It’s utility in the specific circumstance of patients with Myocardial infarction (MI), however, is yet to be established. This meta-analysis aimed to assess the association between the TyG index and cerebrovascular events in patients with MI. Methods: A meta-analysis of studies evaluating the TyG index with MI was conducted using the electronic databases PubMed, Embase, and Google Scholar. Events with values reporting elevation of the TyG index; the 3rd quartile vs the 1st quartile were taken. Forest plots summarizing odds ratios (OR) with 95% confidence intervals (CIs) were analyzed for the primary outcome of stroke and secondary outcomes including Major Adverse Cardiovascular Events (MACE), recurrent Myocardial Infarction (MI), revascularization, and re-hospitalization. A p-value of <0.05 was considered statistically significant. Results: A total of 15 observational studies comprising a total of 119,140 patients with MI were included. For the primary outcome, TyG index was increased with stroke (HR: 1.25, 95% CI: 0.18-2.32, p=0.73); however, not statistically significant. For secondary outcomes, an elevated TyG was associated significantly with increased risk of all-cause mortality (HR: 1.65, 95%CI: 1.27-2.04, p<0.005), MACE (HR: 1.38, 95%CI: 1.18-1.59, p<0.005), cardiovascular cause-specific mortality (HR: 1.71, 95% CI: 1.12-2.29, p<0.005), and revascularization (HR: 2.28, 95%CI:1.32-3.24, p<0.005). Conclusion: A Higher TyG index is significantly associated with an increased risk of cardiovascular outcomes in patients following ACS, making it a useful prognostic marker in cardiovascular risk stratification. However, an increased risk for stroke, it was not statistically significant. Still, further studies are required to show its predictive values and association.