Triglyceride-glucose index as a metabolic risk marker for adverse outcomes after coronary artery bypass grafting: a systematic review and meta-analysis.

AIMS: To evaluate the prognostic value of the triglyceride-glucose index (TyG), a surrogate marker of insulin resistance, for adverse cardiovascular outcomes in patients undergoing coronary artery bypass grafting (CABG).

MATERIALS AND

METHODS

This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies evaluating the association between the TyG index and postoperative outcomes after CABG were retrieved from four databases as of Jul 10, 2026. Multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were used as the primary effect estimates for major adverse cardiovascular events (MACE), with separate analyses conducted for each 1-unit increase in the TyG index and for TyG index tertiles. Crude odds ratios (ORs) comparing the higher TyG group with the lower TyG group were estimated as a supplementary event-based analysis.

RESULTS

Six retrospective cohort reports, comprising 5,978 participants and four independent cohort families, were included, with two being multi-center studies. Each 1-unit increase in the TyG index was associated with a 62.4% higher hazard of MACE (HR: 1.624, 95% CI: 1.349-1.955). Compared with the lowest tertile group, the highest tertile group demonstrated a statistically higher hazard of MACE (HR = 2.093, 95% CI: 1.635-2.680). A higher TyG index was associated with higher odds of MACE (OR: 2.59, 95% CI: 1.97-3.40). In addition, a higher TyG index was associated with an elevated risk of all-cause mortality, nonfatal stroke, and nonfatal myocardial infarction, but was not associated with revascularization.

CONCLUSION

The TyG index may serve as an accessible supplementary metabolic risk marker following CABG. Further prospective validation is required before it is routinely applied to individual risk prediction.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251158075.