Triglyceride-glucose index and coronary artery disease: a systematic review and meta-analysis of risk, severity, and prognosis
Abstract Background The TyG index is an indicator of insulin resistance (IR), which is associated with the development and prognosis of cardiovascular disease. This study aimed to summarize the relationship between the TyG index and the risk, severity, and prognosis of coronary artery disease (CAD)...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-07-01
|
| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-023-01906-4 |
| _version_ | 1797784796220358656 |
|---|---|
| author | Shichu Liang Cui Wang Jing Zhang Zhiyue Liu Yanlin Bai Zhonglan Chen He Huang Yong He |
| author_facet | Shichu Liang Cui Wang Jing Zhang Zhiyue Liu Yanlin Bai Zhonglan Chen He Huang Yong He |
| author_sort | Shichu Liang |
| collection | DOAJ |
| description | Abstract Background The TyG index is an indicator of insulin resistance (IR), which is associated with the development and prognosis of cardiovascular disease. This study aimed to summarize the relationship between the TyG index and the risk, severity, and prognosis of coronary artery disease (CAD) by performing a systematic review and meta-analysis. Methods The PubMed, EMBASE, The Cochrane Library, and Web of Science databases were searched for articles published from inception until May 1, 2023. Cross-sectional studies, retrospective or prospective cohort studies recruiting patients with CAD were included. For the analysis of CAD severity, the outcomes were coronary artery calcification, coronary artery stenosis, coronary plaque progression, multi-vessel CAD, and in-stent re-stenosis. For the analysis of CAD prognosis, the primary outcome was major adverse cardiovascular events (MACE). Results Forty-one studies were included in this study. Compared to patients with the lowest TyG index, those with the highest TyG index had a higher CAD risk [odds ratio (OR): 1.94, 95% confidence interval (CI) 1.20–3.14, I 2 = 91%, P = 0.007]. Additionally, these patients were more likely to have stenotic coronary arteries (OR: 3.49, 95% CI 1.71–7.12, I 2 = 0%, P = 0.0006), progressed plaques (OR: 1.67, 95% CI 1.28–2.19, I 2 = 0%, P = 0.002), and with more vessels involved (OR: 2.33, 95% CI 1.59–3.42, I 2 = 0%, P < 0.0001). When calculated as a categorized variable, it appears that acute coronary syndrome (ACS) patients with higher TyG index levels may have a higher incidence rate of MACE [hazard ratio (HR): 2.09, 95% CI 1.68–2.62, I 2 = 87%, P < 0.00001], whereas chronic coronary syndrome (CCS) or stable CAD patients with higher TyG index levels showed a trend towards an increased incidence rate of MACE (HR: 1.24, 95% CI 0.96–1.60, I 2 = 85%, P = 0.09). When calculated as a continuous variable, ACS patients had an HR of 2.28 per 1-unit/1-standard deviation increment of the TyG index (95% CI 1.44–3.63, I 2 = 95%, P = 0.0005). Similarly, CCS or stable CAD patients had an HR of 1.49 per 1-unit/1-standard deviation increment of the TyG index (95% CI 1.21–1.83, I 2 = 75%, P = 0.0001). Myocardial infarction with non-obstructive coronary arteries patients had an HR of 1.85 per 1-unit increment of the TyG index (95% CI 1.17–2.93, P = 0.008). Conclusions The TyG index is a simple new synthetic index that has been proven to be a valuable tool in the whole-course management of CAD patients. Patients with higher TyG index levels are at a higher risk of CAD, more severe coronary artery lesions, and worse prognosis compared to those with lower TyG index levels. |
| first_indexed | 2024-03-13T00:44:59Z |
| format | Article |
| id | doaj.art-dc4c17b82dbc455199b58fa29e6a2145 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-03-13T00:44:59Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-dc4c17b82dbc455199b58fa29e6a21452023-07-09T11:05:28ZengBMCCardiovascular Diabetology1475-28402023-07-0122112410.1186/s12933-023-01906-4Triglyceride-glucose index and coronary artery disease: a systematic review and meta-analysis of risk, severity, and prognosisShichu Liang0Cui Wang1Jing Zhang2Zhiyue Liu3Yanlin Bai4Zhonglan Chen5He Huang6Yong He7Department of Cardiology, West China Hospital, Sichuan UniversityDepartment of Endocrinology & Metabolism, Laboratory of Endocrinology & Metabolism, and Rare Disease Center, West China Hospital, Sichuan UniversityDepartment of Cardiology, West China Hospital, Sichuan UniversityDepartment of Cardiology, West China Hospital, Sichuan UniversityWest China School of Medicine, West China Hospital, Sichuan UniversityDepartment of Cardiology, West China Hospital, Sichuan UniversityDepartment of Cardiology, West China Hospital, Sichuan UniversityDepartment of Cardiology, West China Hospital, Sichuan UniversityAbstract Background The TyG index is an indicator of insulin resistance (IR), which is associated with the development and prognosis of cardiovascular disease. This study aimed to summarize the relationship between the TyG index and the risk, severity, and prognosis of coronary artery disease (CAD) by performing a systematic review and meta-analysis. Methods The PubMed, EMBASE, The Cochrane Library, and Web of Science databases were searched for articles published from inception until May 1, 2023. Cross-sectional studies, retrospective or prospective cohort studies recruiting patients with CAD were included. For the analysis of CAD severity, the outcomes were coronary artery calcification, coronary artery stenosis, coronary plaque progression, multi-vessel CAD, and in-stent re-stenosis. For the analysis of CAD prognosis, the primary outcome was major adverse cardiovascular events (MACE). Results Forty-one studies were included in this study. Compared to patients with the lowest TyG index, those with the highest TyG index had a higher CAD risk [odds ratio (OR): 1.94, 95% confidence interval (CI) 1.20–3.14, I 2 = 91%, P = 0.007]. Additionally, these patients were more likely to have stenotic coronary arteries (OR: 3.49, 95% CI 1.71–7.12, I 2 = 0%, P = 0.0006), progressed plaques (OR: 1.67, 95% CI 1.28–2.19, I 2 = 0%, P = 0.002), and with more vessels involved (OR: 2.33, 95% CI 1.59–3.42, I 2 = 0%, P < 0.0001). When calculated as a categorized variable, it appears that acute coronary syndrome (ACS) patients with higher TyG index levels may have a higher incidence rate of MACE [hazard ratio (HR): 2.09, 95% CI 1.68–2.62, I 2 = 87%, P < 0.00001], whereas chronic coronary syndrome (CCS) or stable CAD patients with higher TyG index levels showed a trend towards an increased incidence rate of MACE (HR: 1.24, 95% CI 0.96–1.60, I 2 = 85%, P = 0.09). When calculated as a continuous variable, ACS patients had an HR of 2.28 per 1-unit/1-standard deviation increment of the TyG index (95% CI 1.44–3.63, I 2 = 95%, P = 0.0005). Similarly, CCS or stable CAD patients had an HR of 1.49 per 1-unit/1-standard deviation increment of the TyG index (95% CI 1.21–1.83, I 2 = 75%, P = 0.0001). Myocardial infarction with non-obstructive coronary arteries patients had an HR of 1.85 per 1-unit increment of the TyG index (95% CI 1.17–2.93, P = 0.008). Conclusions The TyG index is a simple new synthetic index that has been proven to be a valuable tool in the whole-course management of CAD patients. Patients with higher TyG index levels are at a higher risk of CAD, more severe coronary artery lesions, and worse prognosis compared to those with lower TyG index levels.https://doi.org/10.1186/s12933-023-01906-4Triglyceride-glucose indexInsulin resistanceCoronary artery diseaseRiskSeveriyPrognosis |
| spellingShingle | Shichu Liang Cui Wang Jing Zhang Zhiyue Liu Yanlin Bai Zhonglan Chen He Huang Yong He Triglyceride-glucose index and coronary artery disease: a systematic review and meta-analysis of risk, severity, and prognosis Cardiovascular Diabetology Triglyceride-glucose index Insulin resistance Coronary artery disease Risk Severiy Prognosis |
| title | Triglyceride-glucose index and coronary artery disease: a systematic review and meta-analysis of risk, severity, and prognosis |
| title_full | Triglyceride-glucose index and coronary artery disease: a systematic review and meta-analysis of risk, severity, and prognosis |
| title_fullStr | Triglyceride-glucose index and coronary artery disease: a systematic review and meta-analysis of risk, severity, and prognosis |
| title_full_unstemmed | Triglyceride-glucose index and coronary artery disease: a systematic review and meta-analysis of risk, severity, and prognosis |
| title_short | Triglyceride-glucose index and coronary artery disease: a systematic review and meta-analysis of risk, severity, and prognosis |
| title_sort | triglyceride glucose index and coronary artery disease a systematic review and meta analysis of risk severity and prognosis |
| topic | Triglyceride-glucose index Insulin resistance Coronary artery disease Risk Severiy Prognosis |
| url | https://doi.org/10.1186/s12933-023-01906-4 |
| work_keys_str_mv | AT shichuliang triglycerideglucoseindexandcoronaryarterydiseaseasystematicreviewandmetaanalysisofriskseverityandprognosis AT cuiwang triglycerideglucoseindexandcoronaryarterydiseaseasystematicreviewandmetaanalysisofriskseverityandprognosis AT jingzhang triglycerideglucoseindexandcoronaryarterydiseaseasystematicreviewandmetaanalysisofriskseverityandprognosis AT zhiyueliu triglycerideglucoseindexandcoronaryarterydiseaseasystematicreviewandmetaanalysisofriskseverityandprognosis AT yanlinbai triglycerideglucoseindexandcoronaryarterydiseaseasystematicreviewandmetaanalysisofriskseverityandprognosis AT zhonglanchen triglycerideglucoseindexandcoronaryarterydiseaseasystematicreviewandmetaanalysisofriskseverityandprognosis AT hehuang triglycerideglucoseindexandcoronaryarterydiseaseasystematicreviewandmetaanalysisofriskseverityandprognosis AT yonghe triglycerideglucoseindexandcoronaryarterydiseaseasystematicreviewandmetaanalysisofriskseverityandprognosis |