Type 2 & other diabetes

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

Cardiovasc DiabetolPublished 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

MACE per higher TyG index, by diabetes status

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

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. Cardiovasc Diabetol. Published 4 August 2025. doi:10.1186/s12933-025-02890-7

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