{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:27:43Z","timestamp":1789140463400,"version":"build-2803163510"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The triglyceride-glucose (TyG) index is a simple and reliable marker of insulin resistance and is associated with cardiovascular risk. Epicardial adipose tissue (EAT) volume reflects local visceral fat burden and also correlates with cardiovascular events. While both markers have been studied individually, their combined predictive value for major adverse cardiovascular events (MACE) after coronary artery bypass grafting (CABG) remains unclear. This study evaluated whether TyG index and EAT volume, alone or in combination, can improve risk prediction of MACE following CABG and assessed their potential interaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 304 patients who underwent CABG between 2018 and 2022. TyG index and EAT volume were measured preoperatively. Patients were stratified based on optimal cut-off values derived from ROC analysis. Cox regression models were used to estimate associations with MACE. Interaction was assessed using relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (SI). Model performance was evaluated using C-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Model fit was assessed with the Akaike information criterion (AIC), Bayesian information criterion (BIC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During follow-up of 44 months, 82 patients experienced MACE. Both TyG index and EAT volume were independently associated with increased risk. Patients with elevations in both markers had a significantly higher risk (adjusted HR = 7.62, 95% CI: 3.27\u201317.76). A significant additive interaction was observed (RERI = 3.81; AP = 0.50; SI = 2.34). Adding both variables improved model discrimination and fit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TyG index and EAT volume are independent predictors of MACE after CABG. Their combined assessment provides additional information for risk stratification, but the findings are preliminary and require validation in larger, prospective, multi-center studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2025.1730404","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T05:16:22Z","timestamp":1768367782000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Additive predictive value of triglyceride-glucose index and epicardial adipose tissue volume for major adverse cardiovascular events following coronary artery bypass grafting"],"prefix":"10.3389","volume":"16","author":[{"given":"Juan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Cardiology, The Affiliated Hospital of Qingdao University","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Run","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Affiliated Hospital of Qingdao University","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihui","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Affiliated Hospital of Qingdao University","place":["Qingdao, Shandong, China"]},{"name":"Department of Cardiology, Linzi District Maternal and Child Health Hospital (Qidu Hospital)","place":["Zibo, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimiao","family":"Ruan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Affiliated Hospital of Qingdao University","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Affiliated Hospital of Qingdao University","place":["Qingdao, Shandong, China"]},{"name":"Department of Cardiology, Laizhou People\u2019s Hospital","place":["Yantai, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengliang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Affiliated Hospital of Qingdao University","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangfang","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Navy 971 Hospital","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenzhong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Affiliated Hospital of Qingdao University","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13164600","article-title":"Clinical updates in coronary artery disease: A comprehensive review","volume":"13","author":"Bottardi","year":"2024","journal-title":"J Clin Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.92a.23071","article-title":"Coronary artery bypass grafting: practice trends and projections","volume":"92","author":"Ramsingh","year":"2025","journal-title":"Cleve Clin J Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1097\/CRD.0000000000000621","article-title":"Coronary artery bypass surgery: evidence-based practice","volume":"33","author":"Thuan","year":"2025","journal-title":"Cardiol Rev"},{"key":"B4","doi-asserted-by":"publisher","first-page":"41455","DOI":"10.1038\/s41598-025-25795-7","article-title":"Assessment of right ventricular function in patients after coronary artery bypass graft: A single center study","volume":"15","author":"Taha","year":"2025","journal-title":"Sci Rep"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2025.1661006","article-title":"Comparison in trends and outcomes of multiple vs. Single arterial coronary bypass graft surgery","volume":"12","author":"Ding","year":"2025","journal-title":"Front Cardiovasc Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1186\/s12944-024-02412-6","article-title":"The role of the triglyceride-glucose index as a biomarker of cardio-metabolic syndromes","volume":"23","author":"Gounden","year":"2024","journal-title":"Lipids Health Dis"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S478287","article-title":"Role of triglyceride-glucose index in type 2 diabetes mellitus and its complications","volume":"17","author":"Pan","year":"2024","journal-title":"Diabetes Metab Syndr Obes"},{"key":"B8","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1186\/s12933-019-0957-3","article-title":"High triglyceride-glucose index is associated with poor prognosis in patients with acute st-elevation myocardial infarction after percutaneous coronary intervention","volume":"18","author":"Luo","year":"2019","journal-title":"Cardiovasc Diabetol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.14679","article-title":"Triglyceride-glucose index\u2019s link to cardiovascular outcomes post-percutaneous coronary intervention in China: A meta-analysis","volume":"11","author":"Sun","year":"2024","journal-title":"ESC Heart Fail"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2021.08.026","article-title":"The association between triglyceride-glucose index and major adverse cardiovascular events in patients with acute coronary syndrome - dose-response meta-analysis","volume":"31","author":"Akbar","year":"2021","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2024.103834","article-title":"Is the triglyceride-glucose index ready for cardiovascular risk assessment","volume":"35","author":"D\u2019Elia","year":"2025","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"B12","doi-asserted-by":"publisher","first-page":"6450","DOI":"10.1038\/s41598-025-87967-9","article-title":"Triglyceride-glucose index as a superior marker of insulin resistance for predicting long-term major adverse cardiovascular events following coronary artery bypass grafting in China","volume":"15","author":"Sun","year":"2025","journal-title":"Sci Rep"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1007\/s12928-025-01126-5","article-title":"Pericoronary adipose tissue: potential for pathological diagnosis and therapeutic applications","volume":"40","author":"Hara","year":"2025","journal-title":"Cardiovasc Interv Ther"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1167952","article-title":"The role of epicardial adipose tissue dysfunction in cardiovascular diseases: an overview of pathophysiology, evaluation, and management","volume":"14","author":"Li","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25073583","article-title":"The role of epicardial adipose tissue in acute coronary syndromes, post-infarct remodeling and cardiac regeneration","volume":"25","author":"Krauz","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2025.02.021","article-title":"Clinical role of epicardial adipose tissue","volume":"41","author":"Raggi","year":"2025","journal-title":"Can J Cardiol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3390\/biom14111465","article-title":"Cardio-lipotoxicity of epicardial adipose tissue","volume":"14","author":"Bodenstab","year":"2024","journal-title":"Biomolecules"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2021.111315","article-title":"Adipose tissue and insulin resistance in obese","volume":"137","author":"Ahmed","year":"2021","journal-title":"BioMed Pharmacother"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-008-0032-z","article-title":"Ectopic fat and insulin resistance","volume":"8","author":"Lettner","year":"2008","journal-title":"Curr Diabetes Rep"},{"key":"B20","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1186\/s12916-020-01824-2","article-title":"The triglyceride glucose index is a simple and low-cost marker associated with atherosclerotic cardiovascular disease: A population-based study","volume":"18","author":"Hong","year":"2020","journal-title":"BMC Med"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0288","article-title":"The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp","volume":"95","author":"Guerrero-Romero","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.4097\/kja.19087","article-title":"Multicollinearity and misleading statistical results","volume":"72","author":"Kim","year":"2019","journal-title":"Korean J Anesthesiol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-009-9378-z","article-title":"A conditional synergy index to assess biological interaction","volume":"24","author":"Foraita","year":"2009","journal-title":"Eur J Epidemiol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyr218","article-title":"Recommendations for presenting analyses of effect modification and interaction","volume":"41","author":"Knol","year":"2012","journal-title":"Int J Epidemiol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000096","article-title":"Attributing effects to interactions","volume":"25","author":"VanderWeele","year":"2014","journal-title":"Epidemiology"},{"key":"B26","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1186\/s13098-018-0376-8","article-title":"Metabolic clustering of risk factors: evaluation of triglyceride-glucose index (Tyg index) for evaluation of insulin resistance","volume":"10","author":"Khan","year":"2018","journal-title":"Diabetol Metab Syndr"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2017.32.3.427","article-title":"The cut-off values of triglycerides and glucose index for metabolic syndrome in american and korean adolescents","volume":"32","author":"Moon","year":"2017","journal-title":"J Korean Med Sci"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.5551\/jat.59840","article-title":"Triglyceride-glucose index as a surrogate marker of insulin resistance for predicting cardiovascular outcomes in nondiabetic patients with non-st-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention","volume":"28","author":"Zhao","year":"2021","journal-title":"J Atheroscler Thromb"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S343374","article-title":"Association between triglyceride-glucose index and 2-year adverse cardiovascular and cerebrovascular events in patients with type 2 diabetes mellitus who underwent off-pump coronary artery bypass grafting","volume":"15","author":"Chen","year":"2022","journal-title":"Diabetes Metab Syndr Obes"},{"key":"B30","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1186\/s12933-022-01576-8","article-title":"Triglyceride-glucose index in the prediction of adverse cardiovascular events in patients with premature coronary artery disease: A retrospective cohort study","volume":"21","author":"Wu","year":"2022","journal-title":"Cardiovasc Diabetol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1139\/cjpp-2024-0384","article-title":"Epicardial adipose tissue as target of the incretin-based therapies in cardio-metabolic pathologies: A narrative review","volume":"103","author":"Pop","year":"2025","journal-title":"Can J Physiol Pharmacol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.31083\/RCM26128","article-title":"Targeting epicardial\/pericardial adipose tissue in cardiovascular diseases: A novel therapeutic strategy","volume":"26","author":"Ding","year":"2025","journal-title":"Rev Cardiovasc Med"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2025.133182","article-title":"Pathophysiology of heart failure with preserved ejection fraction in overweight and obesity - clinical and treatment implications","volume":"430","author":"Rodrigues","year":"2025","journal-title":"Int J Cardiol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2025.02.006","article-title":"Uncovering the role of prokineticin pathway on epicardial adipose tissue (Eat) development and eat-associated cardiomyopathy","volume":"35","author":"Vincenzi","year":"2025","journal-title":"Trends Cardiovasc Med"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.36660\/abc.20190197","article-title":"The relationship between epicardial adipose tissue and insulin resistance in obese children","volume":"114","author":"Gunes","year":"2020","journal-title":"Arq Bras Cardiol"},{"key":"B36","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1007\/s11154-021-09708-3","article-title":"Role of anatomical location, cellular phenotype and perfusion of adipose tissue in intermediary metabolism: A narrative review","volume":"23","author":"Camastra","year":"2022","journal-title":"Rev Endocr Metab Disord"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20235989","article-title":"Epicardial adipose tissue: clinical biomarker of cardio-metabolic risk","volume":"20","author":"Villasante Fricke","year":"2019","journal-title":"Int J Mol Sci"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2011.04140.x","article-title":"Coronary artery disease is associated with higher epicardial retinol-binding protein 4 (Rbp4) and lower glucose transporter (Glut) 4 levels in epicardial and subcutaneous adipose tissue","volume":"76","author":"Salgado-Somoza","year":"2012","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1177\/10742484231151820","article-title":"Epicardial adipose tissue and diabetic cardiomyopathy","volume":"28","author":"Yang","year":"2023","journal-title":"J Cardiovasc Pharmacol Ther"},{"key":"B40","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1007\/s11906-019-0939-6","article-title":"Epicardial adipose tissue and cardiovascular disease","volume":"21","author":"Le Jemtel","year":"2019","journal-title":"Curr Hypertens Rep"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2007.03.019","article-title":"Human epicardial adipose tissue: A review","volume":"153","author":"Sacks","year":"2007","journal-title":"Am Heart J"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1730404\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T05:38:54Z","timestamp":1771911534000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1730404\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,14]]},"references-count":41,"alternative-id":["10.3389\/fendo.2025.1730404"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1730404","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,14]]},"article-number":"1730404"}}