Table 1 Characteristics and results of studies regarding TyG index in cardiovascular diseases
From: Triglyceride-glucose index as a marker in cardiovascular diseases: landscape and limitations
Author, year, and country | Study design and population | Outcomes evaluated and evaluation methods | Adjusted variables | Key findings |
|---|---|---|---|---|
Stable Coronary artery disease | ||||
 Jin, 2018, China [22] | Case–control, 1282 T2DM with new-onset, stable CAD | Incidence of MACCEs during follow up | Age, sex, body mass index, hypertension, family history of CAD, smoke, HDL-C, non-HDL-C, creatinine, UA, hsCRP, Gensini score | TyG index was associated with increased risk of MACCEs (HR: 1.693, 95% CI: 1.238–2.316) |
 Jin, 2018, China [23] | Case–control, 3745 patients with stable CAD | Incidence of CVEs | BMI, LVEF, hypertension, DM, UA, smoke, hsCRP, HDL-C, LDL-C | TyG index was positively associated with CVES (HR: 1.364, 95% CI: 1.100–1.691) |
 Gao, 2021, China [24] | Observational study, 1093 CAD patients with CTO lesion | Coronary collateralization grading evaluated by Rentrop score | Age, sex, BMI, hypertension, hypercholesterolemia, T2DM, smoke, stroke, UA, monocyte count, hsCRP | TyG index was correlated with the occurrence of impaired collateralization (OR: 1.59–5.72) in the T2 and T3 group compared with the first tertile group |
 Lee, 2016, Korea [25] | observational Study, 888 asymptomatic adults with T2DM | CAS evaluated by coronary CT angiography | Age, sex, glycemic control, blood pressure, LDL-C, medication | TyG index was an independent risk factor for CAS (OR:3.19, 95% CI: 1.371–7.424) |
 Si, 2021, China [79] | Observational study, 697 asymptomatic patients | CACS evaluated by coronary CT angiography | Age, smoke, hypertension, DM, LDL-C | TyG index was an independent risk factor for CAD (OR:2.007, 95% CI: 1.066–3.780) |
 Thai, 2020, Vietnam [26] | Cross-sectional observational study, 166 patients with T2DM | CAS evaluated by coronary CT angiography | Duration of diabetes, BMI, eGFR, physical activity, smoke, HbA1c, blood pressure | TyG index threshold at 10 resulted in 57% sensitivity and 75% specificity for predicting the presence of CS ≥ 70% |
 Park, 2020, Korea [29] | Retrospective, observational study, 1250 asymptomatic individuals without traditional CVRFs | CAS evaluated by coronary CT angiography | Age, sex, blood pressure, BMI, LDL-C, HDL-C, UA | TyG index had an incremental impact on CAD (OR: 1.473, 95%CI: 1.026–2.166) |
 Silva, 2019, Brazil [80] | Observational study, 2330 at least had one CVD in the last 10 years | Evaluation of risk factors for CAD | Sex, age, medication, presence of disease history | TyG index was positively associated with a higher prevalence of symptomatic CAD |
 Yang, 2021, China [81] | Prospective observational study, 5489 nondiabetic patients after PCI | Incidence of MACCEs during follow up | Age, sex, previous PCI/CABG, LVEF, HbA1c, TG, hsCRP | TyG index was not independently related to MACE for nondiabetic patients who underwent PCI (HR: 0.77, 95%CI 0.56–1.16) |
 Si, 2021, china [82] | Observational study, 680 CAD with T2DM, 985 non-CAD without T2DM | Identification of risk factors for CAD with T2DM | BMI, smoke, blood pressure, DM, ischemic stroke | TyG index was an independent risk factor for CAD with T2DM (OR:2.641, 95% CI: 1.154–6.045) |
 Chen, 2022, China [83] | Observational study, 1578 diabetic patients with OPCABG | Incidence of MACCEs during follow up | CKD, preoperative LVEF, insulin dependence, LDL-C, HDL-C, extent of CAD, left main disease, use of arterial graft, complete revascularization, use of IABP | TyG index was significantly and positively associated with MACCEs after OPCABG in patients with T2DM (OR:2.133, 95% CI: 1.347–3.377) |
Acute coronary syndrome | ||||
 Wang, 2020, China [32] | Retrospective, observational study, 2531 ACS patients with diabetes | New-onset MACEs during 3-year follow up | Age, sex, smoke, previous MI and CABG, BMI, LVEF, multi-vessel disease, left main disease, HbA1c, hsCRP, statin and insulin use | TyG index was an independent predictor of MACEs (HR:1.455, 95% CI: 1.208–1.753) |
 Luo, 2019, China [33] | Retrospective, observational study, 1092 STEMI patients | Incidence of MACCEs during follow up | Age, blood pressure, smoke, platelet counts, albumin, HbA1c, UA, eGFR, three-vessel disease, number of stents | TyG index was positively associated with an increased risk of MACCEs (HR:1.529, 95% CI: 1.001–2.061) |
 Mao, 2019, China [34] | Observational study, 438 patients with NSTE-ACS | Incidence of MACEs during follow up | Age, Mets, LDL-C, HDL-C, eGFR, Killip class, GRACE score, CRP | TyG index was an independent predictor of the occurrence of the MACEs (HR:1.878, 95% CI: 1.130–3.121) |
 Zhang, 2022, China [35] | Observational study, 1655 nondiabetic patients with ACS with LDL-C < 1.8 mmol/l | Incidence of MACEs during follow up | Multi-vessel disease, PCI/CABG | TyG index was positively associated with revascularization (HR: 1.67, 95% CI: 1.02–2.75) |
 Drwita, 2021, Poland [84] | Observational study, 1340 nondiabetic patients with AMI | Incidence of MACEs during1-yaer follow up | CAD, eGFR, LDL-C, TC | TyG index was not independently related to MACE for nondiabetic patients who underwent PCI |
 Gao, 2021, China [36] | Prospective, observational study 1179 MINOCA patients | Incidence of MACEs during follow up | Age, sex, MI type, hypertension, diabetes, dyslipidemia | TyG index was significantly associated with an increased risk of MACE (HR: 1.33, 95% CI: 1.04–1.69) |
 Guo, 2022, China [85] | Retrospective, observational study 2030 prediabetic patients with ACS | Incidence of MACCEs during follow up | Age, sex, BMI, blood pressure, smoke, LDL-C, HDL-C, Cr, UA, eGFR, BNP, CRP, DM, hypertension | TyG index was significantly associated with an increased risk of MACCE (HR: 3.256, 95% CI: 2.618–4.749) |
 Jiao, 2022, China [86] | Observational study 662 ACS patients over 80 years old | Incidence of all cause of death and MACEs during follow up | Age, gender, BMI, blood pressure, LVEF, Gensini score, hypertension, diabetes, DM, previous MI, previous stroke, CKD, current smoking, TC, LDL-C, HDL-C, eGFR, UA, medication, LM lesion, multivessel lesion and treatment | TyG index is an independent predictor of long-term all-cause mortality (HR: 1.64, 95% CI: 1.06–2.54) and MACE (HR: 1.36, 95% CI: 1.05–1.95) |
 Zhao, 2021, China [87] | Observational study 1510 NSTE-ACS patients received elective PCI without diabetes | Incidence of MACEs during follow up | Age, gender, BMI, smokie, hypertension, dyslipidemia, previous history of MI, PCI, stroke, PAD, LM disease, three-vessel disease, chronic total occlusion, diffuse lesion, in-stent restenosis, SYNTAX score, treatment of LM, LCX, RCA, DES implantation, DCB application, complete revascularization, number of stents | TyG index is an independent predictor of MACE (HR: 2.433, 95% CI 1.853–3.196) |
 Ma, 2020, China [88] | Observational study 776 ACS with T2DM patients received PCI | Incidence of MACEs during follow up | Age, BMI, cblood pressure, HDL-Cl, HbA1c, sex, smoke, drinking, presence of peripheral artery disease, chronic kidney disease, cardiac failure, previous myocardial infarction, past percutaneous coronary intervention, medication, coronary artery disease severity, presence of lesions > 20 mm long, use of drug-coated balloon, complete revascularization | TyG index is an independent predictor of MACE (HR:2.17, 95% CI: 1.45–3.24) |
 Yang, 2022, China [89] | Retrospective, observational study 549 STEMI with NOAF patients | Incidence of MACEs during hospitalization and follow up | Age, hypertension, DM, BMI, Hb, WBC, neutrophil, platelet, glucose, TG, TC, HDL-c, LDL-c, eGFR, Left atrium diameter, LVEF, SS, Stent length, Killip class ≥ II | TyG index is an independent predictor of NOAF during hospitalization (OR: 8.884, 95% CI: 1.570–50.265) |
 Zhao, 2021, China [90] | Observational study 274 STEMI patients over 18 years old received OCT | Incidence of MACEs during follow up | Age, sex, LVEF, smoke, hypertension, hyperlipidemia, DM; Cr, heart rate, CRP | The middle tertile of TyG was associated with greater rates of MACEs in patients with PR but not in those with PE (HR: 6.01; 95% CI: 1.25–28.88) |
Zhang, 2021, China [91] | Observational study 1932 ACS patients with T2DM | Incidence of MACCEs during follow up | Age, sex, BMI, blood pressure, medical history, smoke, duration of diabetes | TyG index is an independent predictor of MACCES in patients with T2DM and ACS (OR: 2.32, 95% CI: 1.92–2.80) |
 Zhang, 2020, China [92] | Observational study 3181 ACS patients | Incidence of MACEs during follow up | Age, gender, DM, hypertension, previous AMI, hemoglobin, albumin, eGFR, TGs, LVEF, multi-vessel/ left main coronary artery | TyG index was positively associated with MACEs (HR:1.19, 95% CI: 1.01–1.41) in patients with AMI |
 Hu, 2020, China [93] | Observational study 9285 ACS patients received PCI | Incidence of MACEs during follow up | Age, sex, smoke, hypertension, previous MI, previous stroke, previous PCI, previous CABG, ACS status, medication | High TyG index had a significantly greater risk of cardiovascular events regardless of diabetes status (HR:1.92, 95% CI: 1.33–2.77) |
 Zhao, 2020, China [94] | Observational study 798 NSTE-ACS patients with diabetes received PCI | Incidence of MACEs during follow up | Age, sex, BMI, blood pressure, smoke, drinking, duration of diabetes, dyslipidemia, prior MI, PCI, stroke, PVD, TC, HDL-C, eGFR, HbA1c, LVEF, SYNTAX score, LM treatment, DCB use, complete revascularization and number of stents, medication | TyG index was independently associated with higher risk of MACEs in NSTE-ACS patients with diabetes |
In-stent restenosis | ||||
 Zhu, 2021, China [39] | Retrospective study, 1574 ACS patients with DES-based PCI | Incidence of ISR evaluated by follow-up angiography | Age, sex, BMI, LVEF, hsCRP, hypertension, DM, previous PCI, SYNTAX score, target vessel in LAD or RCA, application of intracoronary imagine; DES-sirolimus; total length of stents, and minimal stent diameter | TyG index was positively associated with DES-ISR (OR: 1.424, 95% CI: 1.116–1.818) |
Arterial stiffness | ||||
 Lambrinoudaki, 2018, Greece [44] | Cross-sectional study, 473 non-diabetic postmenopausal women, without overt CVD | Carotid IMT, flow-mediated dilation of the brachial artery, PWV evaluated by ultrasound image | Mets, age, BMI, LDL-C, smoke, hypertension | TyG index was associated with carotid atherosclerosis and AS in lean postmenopausal women (OR: 3.119, 95% CI: 1.187–8.194) |
 Lee, 2018, Korea [45] | Observational study, 3587 healthy subjects | AS evaluated by baPWV | Age, blood pressure, BMI, LDL-C, HDL-C, DM, menopause | TyG index was significantly associated with increased baPWV (OR: 2.92, 95% CI: 1.92–4.44 in men, OR: 1.84, 95% CI: 1.15–2.96 in women) |
 Won, 2018, Korea [46] | Cross-sectional study, 2560 subjects without CAD, stroke, and malignancies | AS evaluated by baPWV | Age, sex, blood pressure, abdominal obesity, HDL, smoke, DM | TyG index was independently related to the baPWV (β = 0.158) |
 Su, 2021, China [47] | Cross-sectional study, 2035 subjects over 60 years old | AS evaluated by baPWV | Age, sex, BMI, waist circumference, SBP, DBP, TC, HDL-C, LDL-C, UA, eGFR, smoke, drinking status, CAD, hypertension, DM, anti-platelet agents, anti-hypertensive agents, hypoglycemic therapy, lipid-lowering therapy | TyG index was positively associated with baPWV (OR: 1.32, 95% CI: 1.09–1.60) |
 Li, 2020, China [50] | Observational study, 4718 patients with hypertension | AS evaluated by baPWV | Age, sex, education, BMI, waist circumference, physical activity, smoke, current drinking, blood pressure, UA, serum homocysteine, HDL-C, LDL-C, eGFR, DM, antihypertensive drugs, antiplatelet drugs | TyG index was positively associated with baPWV (OR: 2.12, 95% CI: 1.80–2.50) |
 Nakagomi, 2020, Japan [51] | Observational study, 1720 healthy men and 1098 healthy women aged between 25 and 55 years | AS evaluated by baPWV | Age, BMI, blood pressure, HbA1c, FBG, LDL-C, HDL-C, UA, smoke, alcohol drinking | TyG index was positively associated with baPWV (95% CI: 0.11–0.14) |
 Wu, 2021, China [52] | Cross-sectional study, 1895 prehypertensive patients | AS evaluated by baPWV | Age, sex, BMI, smoke, drinking, physical activity, DM, dyslipidaemia, FBG, TG, PBG, LDL-C, eGFR, UA, homocysteine, medications | TyG index was positively associated with baPWV (95% CI: 58.7–200.0) |
 Wang, 2021, China [53] | Observational study, 3185 patients with T2DM | AS evaluated by baPWV | BMI, waist circumference, blood pressure, LDL-C, HDL-C, WBC counts, smoke, drinking, medication | TyG index was positively associated with baPWV (OR: 1.40, 95% CI: 1.16–1.70) |
 Guo, 2021, China [54] | Observational study 13,706 healthy subjects | AS evaluated by baPWV, 10-year CVD risk was evaluated using the Framingham risk score | age, smoke, BMI, pulse pressure, HbA1c, TC, LDL-C, HDL-C, UA, medication | TyG index was independently associated with AS (OR: 1.514, 95% CI: 1.371–1.671) and 10-year CVD risk (OR: 1.420, 95% CI: 1.147–1.756) |
 Yan, 2022, China [95] | Cross-sectional study 2480 individuals from Hanzhong Adolescent Hypertension Cohort study | AS evaluated by baPWV | Age, sex, smoke, alcohol drinking, regular exercise, BMI, blood pressure, hs-CRP, diabetes | Higher long-term trajectory of TyG index were independently associated with increased arterial stiffness (OR: 2.760, 95% CI: 1.40–7.54) |
 Wu, 2021, China [96] | Prospective study 6028 individuals from Kailuan study | AS evaluated by baPWV | Age, se, smoke, alcohol drinking, physical activity, MAP, diabetes, hs-CRP, and BMI at baseline | TyG index was independently associated with AS (HR: 1.58, 95% CI: 1.25–2.01) |
Coronary artery calcification | ||||
 Kim, 2017, Korea [57] | Observational study 4319 healthy subjects | CAC evaluated by multidetector CT scanner | Age, sex, blood pressure, BMI, LDL-C, HDL-C, smoke, alcohol, exercise habits | TyG index was independently associated with CAC (OR: 1.950, 95% CI: 1.23–3.11) |
 Won, 2020, Korea [58] | Observational study 12,326 asymptomatic subjects | CAC evaluated by multidetector CT scanner | Age, male sex, BMI, blood pressure, TC, TG, HDL-C, LDL-C, glucose, and creatinine, smoke | TyG index was significantly associated with CAC progression in baseline CACS ≤ 100 |
 Park, 2019, Korea [97] | Retrospective study 1175 individuals | CAC evaluated by multidetector CT scanner | Age, sex, BMI, blood pressure, LDL-C, HDL-C, exercise, alcohol, smoking, presence of diabetes and hypertension, medication | TyG index is an independent predictor of CAC progression (OR: 1.82, 95% CI: 1.20–2.77) |
Heart failure | ||||
 Guo, 2021, China [61] | Retrospective study, 546 patients with CHF and T2DM | Cardiovascular death or rehospitalization due to HF during follow up | Age, sex, BMI, blood pressure, HR, CRP, eGFR, NT-proBNP, HbA1c, LVEF, AF, NYHA | TyG index was positively associated with cardiovascular death (HR: 4.42, 95% CI: 1.49–13.15) and rehospitalization (HR: 1.84, 95% CI: 1.16–2.91) |
 Yang, 2021, China [63] | Retrospective study, 103 hospitalized HF patients | ECV fraction calculated by CMR measurements and T1 mapping, all-cause death or HF rehospitalization during follow up | age, DM, HbA1c, NT-proBNP | TyG index was the significant factor determined for ECV fraction (r partial = 0.36) and primary outcome events (HR = 2.01, 95% CI = 1.03–4.01) |