An elevated Triglyceride-Glucose index was significantly associated with a 65% increased risk of all-cause mortality and a 138% increased risk of MACE in myocardial infarction patients.
Does an elevated Triglyceride-Glucose (TyG) index predict stroke and cardiovascular events in patients with myocardial infarction?
An elevated TyG index is significantly associated with an increased risk of MACE, mortality, and revascularization, but not stroke, in patients following myocardial infarction.
Background: The Triglyceride-Glucose (TyG) index has recently come under study as a reliable, inexpensive marker of insulin resistance. It is garnering attention as a potential tool for prognostication in cardiovascular disease. It’s utility in the specific circumstance of patients with Myocardial infarction (MI), however, is yet to be established. This meta-analysis aimed to assess the association between the TyG index and cerebrovascular events in patients with MI. Methods: A meta-analysis of studies evaluating the TyG index with MI was conducted using the electronic databases PubMed, Embase, and Google Scholar. Events with values reporting elevation of the TyG index; the 3rd quartile vs the 1st quartile were taken. Forest plots summarizing odds ratios (OR) with 95% confidence intervals (CIs) were analyzed for the primary outcome of stroke and secondary outcomes including Major Adverse Cardiovascular Events (MACE), recurrent Myocardial Infarction (MI), revascularization, and re-hospitalization. A p-value of <0.05 was considered statistically significant. Results: A total of 15 observational studies comprising a total of 119,140 patients with MI were included. For the primary outcome, TyG index was increased with stroke (HR: 1.25, 95% CI: 0.18-2.32, p=0.73); however, not statistically significant. For secondary outcomes, an elevated TyG was associated significantly with increased risk of all-cause mortality (HR: 1.65, 95%CI: 1.27-2.04, p<0.005), MACE (HR: 1.38, 95%CI: 1.18-1.59, p<0.005), cardiovascular cause-specific mortality (HR: 1.71, 95% CI: 1.12-2.29, p<0.005), and revascularization (HR: 2.28, 95%CI:1.32-3.24, p<0.005). Conclusion: A Higher TyG index is significantly associated with an increased risk of cardiovascular outcomes in patients following ACS, making it a useful prognostic marker in cardiovascular risk stratification. However, an increased risk for stroke, it was not statistically significant. Still, further studies are required to show its predictive values and association.
Shrestha et al. (2026) studied this question. An elevated Triglyceride-Glucose index was significantly associated with a 65% increased risk of all-cause mortality and a 138% increased risk of MACE in myocardial infarction patients.