A higher triglyceride-glucose index is associated with an increased risk of coronary artery disease (CAD), according to a systematic review and meta-analysis published in Cardiovascular Diabetology. Individuals with a higher triglyceride-glucose index are also more likely to have more severe coronary artery lesions and a poorer prognosis compared with patients with a lower index, according to the report.
Researchers performed the systematic review and meta-analysis using cohort and cross-sectional studies (n=41) that included patients with CAD. The primary CAD severity outcomes were coronary artery calcification (CAC), coronary artery stenosis, coronary plaque progression, multi-vessel CAD, and in-stent re-stenosis, while primary prognostic outcome was a major adverse cardiovascular event (MACE; all-cause death, stroke, myocardial infarction, and heart failure).
A pooled analysis of studies revealed that a higher triglyceride-glucose index is associated with a greater CAD risk, (odds ratio [OR], 1.94; 95% CI, 1.20-3.14; P =.007), according to the report. Higher triglyceride index also increased the likelihood of a stenotic coronary artery (OR, 3.49; 95% CI, 1.71-7.12; P =.0006), plaque progression (OR, 1.67; 95% CI, 1.28-2.19; P =.002), and multi-vessel involvement (OR, 2.33; 95% CI, 1.59-3.42; P <.0001).
A meta-analysis of 13 studies found a significantly higher MACE incidence among individuals with a higher triglyceride-glucose index and concomitant CAD (hazard risk [HR], 2.09; 95% CI, 1.68-2.62; P <.00001). A total of 4 studies analyzed triglyceride-glucose index as a continuous variable, and found the risk of MACE increased by 1.49 times per 1-unit/1-SD increment of the triglyceride-glucose index (95% CI, 1.21-1.83; P =.0001), and 1 study found that a 1-unit increment increase of the triglyceride-glucose index increased the HR of MACE by 1.85 (95% CI, 1.17-2.93; P =.008).
An inability to determine causality due to the cross-sectional nature of some studies and an inability to control for confounding factors, such as exercise and diet, are acknowledged limitations to the research.
“In the whole-course management of CAD patients, monitoring changes in the [triglyceride-glucose] index over time may be helpful in ensuring comprehensive and effective treatment,” according to the study authors.
Liang S, Wang C, Zhang J, et al. Triglyceride-glucose index and coronary artery disease: a systematic review and meta-analysis of risk, severity, and prognosis. Cardiovasc Diabetol. Published online July 6, 2023. doi:10.1186/s12933-023-01906-4