Prognostic Significance of Triglyceride-Glucose Index for Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis
Background: Insulin resistance (IR) represents a critical regulator in the development and progress of coronary artery disease (CAD). Triglyceride-glucose (TyG) index, a novel surrogate biomarker of IR, has been implicated in several cardiovascular diseases. Accordingly, we conduct a meta-analysis t...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-12-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.774781/full |
| _version_ | 1818425119534481408 |
|---|---|
| author | Jin-Wen Luo Wen-Hui Duan Yan-Qiao Yu Lei Song Da-Zhuo Shi |
| author_facet | Jin-Wen Luo Wen-Hui Duan Yan-Qiao Yu Lei Song Da-Zhuo Shi |
| author_sort | Jin-Wen Luo |
| collection | DOAJ |
| description | Background: Insulin resistance (IR) represents a critical regulator in the development and progress of coronary artery disease (CAD). Triglyceride-glucose (TyG) index, a novel surrogate biomarker of IR, has been implicated in several cardiovascular diseases. Accordingly, we conduct a meta-analysis to elucidate the relationship between TyG index and adverse cardiovascular events in patients with CAD.Methods: To identify the studies examining the predictive capacity of the TyG index for adverse cardiovascular events in the setting of CAD, we performed a comprehensive literature retrieval of Scopus, PubMed, EMBASE, and Web of Science, from the inception of databases to October 5, 2021. We pooled the adjusted hazard ratio (HR) along with 95% CI using a random-effects model. The primary outcome was a composite of major adverse cardiovascular events (MACEs), including all-cause death, cardiovascular death (CV death), myocardial infarction (MI), stroke, hospitalization for unstable angina or heart failure, and revascularization. The secondary outcomes were all-cause death, CV death, MI, stroke, and revascularization. Additionally, we conducted subgroup analyses stratified by diabetes status, age, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), category of TyG index, sample size, follow-up duration, and study design.Results: About 12 studies involving 28,795 patients with CAD were finally taken into the quantitative analysis. Our findings showed that there was a 2.14-fold higher risk of MACEs among CAD populations in the highest TyG group compared with those in the lowest TyG group (HR: 2.14, 95% CI: 1.69–2.71, P < 0.001). A greater risk of MACEs was observed in participants with higher BMI than those with lower BMI (P = 0.03 for interaction). In the analysis of secondary outcomes, we also observed a markedly increased risk of MI, stroke, and revascularization in the highest TyG group compared with the lowest TyG group. No evidence of a significant association between TyG index and CV mortality or all-cause mortality in patients with CAD was identified.Conclusions: The elevated TyG index is a promising predictive factor of adverse cardiovascular events in patients with CAD.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42021228521. |
| first_indexed | 2024-12-14T14:08:52Z |
| format | Article |
| id | doaj.art-46771835779543d6b2acc04f5d396013 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-14T14:08:52Z |
| publishDate | 2021-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-46771835779543d6b2acc04f5d3960132022-12-21T22:58:22ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-12-01810.3389/fcvm.2021.774781774781Prognostic Significance of Triglyceride-Glucose Index for Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Systematic Review and Meta-AnalysisJin-Wen Luo0Wen-Hui Duan1Yan-Qiao Yu2Lei Song3Da-Zhuo Shi4National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Science, Beijing, ChinaNational Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Science, Beijing, ChinaGraduate School, Beijing University of Chinese Medicine, Beijing, ChinaGraduate School, Beijing University of Chinese Medicine, Beijing, ChinaNational Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Science, Beijing, ChinaBackground: Insulin resistance (IR) represents a critical regulator in the development and progress of coronary artery disease (CAD). Triglyceride-glucose (TyG) index, a novel surrogate biomarker of IR, has been implicated in several cardiovascular diseases. Accordingly, we conduct a meta-analysis to elucidate the relationship between TyG index and adverse cardiovascular events in patients with CAD.Methods: To identify the studies examining the predictive capacity of the TyG index for adverse cardiovascular events in the setting of CAD, we performed a comprehensive literature retrieval of Scopus, PubMed, EMBASE, and Web of Science, from the inception of databases to October 5, 2021. We pooled the adjusted hazard ratio (HR) along with 95% CI using a random-effects model. The primary outcome was a composite of major adverse cardiovascular events (MACEs), including all-cause death, cardiovascular death (CV death), myocardial infarction (MI), stroke, hospitalization for unstable angina or heart failure, and revascularization. The secondary outcomes were all-cause death, CV death, MI, stroke, and revascularization. Additionally, we conducted subgroup analyses stratified by diabetes status, age, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), category of TyG index, sample size, follow-up duration, and study design.Results: About 12 studies involving 28,795 patients with CAD were finally taken into the quantitative analysis. Our findings showed that there was a 2.14-fold higher risk of MACEs among CAD populations in the highest TyG group compared with those in the lowest TyG group (HR: 2.14, 95% CI: 1.69–2.71, P < 0.001). A greater risk of MACEs was observed in participants with higher BMI than those with lower BMI (P = 0.03 for interaction). In the analysis of secondary outcomes, we also observed a markedly increased risk of MI, stroke, and revascularization in the highest TyG group compared with the lowest TyG group. No evidence of a significant association between TyG index and CV mortality or all-cause mortality in patients with CAD was identified.Conclusions: The elevated TyG index is a promising predictive factor of adverse cardiovascular events in patients with CAD.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42021228521.https://www.frontiersin.org/articles/10.3389/fcvm.2021.774781/fulltriglyceride-glucose indexinsulin resistancecoronary artery diseaseadverse cardiovascular eventsmeta-analysis |
| spellingShingle | Jin-Wen Luo Wen-Hui Duan Yan-Qiao Yu Lei Song Da-Zhuo Shi Prognostic Significance of Triglyceride-Glucose Index for Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis Frontiers in Cardiovascular Medicine triglyceride-glucose index insulin resistance coronary artery disease adverse cardiovascular events meta-analysis |
| title | Prognostic Significance of Triglyceride-Glucose Index for Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis |
| title_full | Prognostic Significance of Triglyceride-Glucose Index for Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis |
| title_fullStr | Prognostic Significance of Triglyceride-Glucose Index for Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Prognostic Significance of Triglyceride-Glucose Index for Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis |
| title_short | Prognostic Significance of Triglyceride-Glucose Index for Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis |
| title_sort | prognostic significance of triglyceride glucose index for adverse cardiovascular events in patients with coronary artery disease a systematic review and meta analysis |
| topic | triglyceride-glucose index insulin resistance coronary artery disease adverse cardiovascular events meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.774781/full |
| work_keys_str_mv | AT jinwenluo prognosticsignificanceoftriglycerideglucoseindexforadversecardiovasculareventsinpatientswithcoronaryarterydiseaseasystematicreviewandmetaanalysis AT wenhuiduan prognosticsignificanceoftriglycerideglucoseindexforadversecardiovasculareventsinpatientswithcoronaryarterydiseaseasystematicreviewandmetaanalysis AT yanqiaoyu prognosticsignificanceoftriglycerideglucoseindexforadversecardiovasculareventsinpatientswithcoronaryarterydiseaseasystematicreviewandmetaanalysis AT leisong prognosticsignificanceoftriglycerideglucoseindexforadversecardiovasculareventsinpatientswithcoronaryarterydiseaseasystematicreviewandmetaanalysis AT dazhuoshi prognosticsignificanceoftriglycerideglucoseindexforadversecardiovasculareventsinpatientswithcoronaryarterydiseaseasystematicreviewandmetaanalysis |