Does diabetes status modify the association between the triglyceride-glucose index and major adverse cardiovascular events in patients with coronary heart disease? A systematic review and meta-analysis of longitudinal cohort studies
Authors' conclusion
Higher TyG index values appear to be associated with an increased risk of adverse cardiovascular events, all-cause mortality, nonfatal myocardial infarction, and revascularization in both diabetic and nondiabetic patients with CHD. However, no significant association was found between the TyG index and the risk of nonfatal stroke in nondiabetic patients. These findings suggest that the TyG index may offer potential prognostic value in CHD, but further high-quality prospective studies are warranted to confirm these associations and clarify their clinical implications.
Study context
- Population
- Patients with coronary heart disease (CHD) in cohort studies; databases searched from inception to March 13, 2025
- Participants
- 173,851 patients36 cohort studies
- Comparison
- Higher vs lower triglyceride-glucose (TyG) index, by diabetes status
- Diabetesn = 119,232
- No diabetesn = 54,619
- Outcome
- MACE (all-cause mortality, nonfatal MI, nonfatal stroke, revascularization) by TyG index
Methodological detailsfixed-effect or random-effects model depending on heterogeneity, subgroup analysis and meta-regression, Study quality assessed with the Newcastle-Ottawa Scale
- Fixed-effect or random-effects model depending on heterogeneity
- Subgroup analysis and meta-regression
- Study quality assessed with the Newcastle-Ottawa Scale
Pooled result
As reported in the abstract
Diabetes: MACE, categorical HR
1.98
95% CI 1.61–2.43
Diabetes: MACE, continuous HR
1.57
95% CI 1.38–1.78
No diabetes: MACE, categorical HR
1.65
95% CI 1.33–2.05
No diabetes: MACE, continuous HR
1.74
95% CI 1.46–2.06
Further pooled results
All-cause mortality
- Diabetes: HR
- 1.74 (95% CI 1.45-2.08)
- No diabetes: HR
- 1.50 (95% CI 1.18-1.90)
Nonfatal MI
- Diabetes: HR
- 2.05 (95% CI 1.52-2.77)
- No diabetes: HR
- 2.46 (95% CI 1.11-5.47)
Nonfatal stroke
- Diabetes: HR
- 1.73 (95% CI 1.12-2.66)
- No diabetes: HR, no association
- 1.66 (95% CI 0.88-3.12)
Revascularization
- Diabetes: HR
- 2.52 (95% CI 1.26-5.04)
- No diabetes: HR
- 2.09 (95% CI 1.57-2.76)
Original publication
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