The prognostic value of triglyceride-glucose index in pre-dicting coronary artery disease and long term clinical out-come

XU Hai-jia; ZOU Yu-fang; QU Wei

摘要：Background Insulin resistance(IR)is linked to coronary artery disease(CAD)and cardiovascular events.The triglyceride-glucose(TyG)index is a simple marker for IR,but its role in predicting CAD severity and long-term clinical outcomes in people without previous heart disease is unclear.Methods This retrospective study included 619 patients who underwent elective coronary angiography for CAD evaluation.The TyG index was calculated us-ing the formula Ln[fasting triglycerides(mg/dL)×fasting blood glucose(mg/dL)/2].Clinical characteristics,labo-ratory results,and medication use were collected,and the severity of CAD was assessed by coronary angiography.During a median follow-up period of 30 months,the incidence of long-term major adverse cardiovascular events(MACE),including acute myocardial infarction(AMI),revascularization,stroke,and all-cause death,was record-ed.The association between the TyG index and the incidence of MACE was analyzed using Cox regression models.Results The TyG index was notably higher in the CAD group[10.1(9.8-10.5)vs.8.9(8.5-9.1),P<0.001].The TyG index was significantly associated with CAD severity,with higher TyG levels corresponding to greater steno-sis in the coronary arteries.Higher TyG index levels were also linked to an increased incidence of MACE,particu-larly AMI.In multivariate analysis,the TyG index was identified as an independent predictor of MACE(HR:2.117,95%CI:1.308-3.425,P=0.002).Kaplan-Meier curves showed that individuals in the high TyG index tertile had sig-nificantly higher MACEs rate compared to those in the low and medium TyG groups(P<0.0001).Conclusions The TyG index is a significant predictor of CAD severity and MACE in individuals without prior heart disease.This study highlighted the prognostic value of the TyG index in cardiovascular risk assessment,suggesting that it might be a valuable tool for identifying individuals at higher risk of severe CAD and adverse cardiovascular outcomes.[S Chin J Cardiol 2025;26(1):21-28]