{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:07:45Z","timestamp":1789103265460,"version":"build-2803163510"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"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>Aims<\/jats:title>\n                    <jats:p>To evaluate the prognostic value of the triglyceride\u2013glucose index (TyG), a surrogate marker of insulin resistance, for adverse cardiovascular outcomes in patients undergoing coronary artery bypass grafting (CABG).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u00a0=\u00a02.093, 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:ext-link>\n                      , identifier CRD420251158075\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1909829","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:33:00Z","timestamp":1789101180000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Triglyceride\u2013glucose index as a metabolic risk marker for adverse outcomes after coronary artery bypass grafting: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Yuhan","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yirui","family":"Ning","sequence":"additional","affiliation":[{"name":"Xiangya School of Medicine, Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiyu","family":"Wang","sequence":"additional","affiliation":[{"name":"The Second Xiangya Hospital of Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinwu","family":"Yang","sequence":"additional","affiliation":[{"name":"The First Clinical Medical College, Shanxi Medical University","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaobo","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University","place":["Changsha, Hunan, China"]},{"name":"Hunan Provincial Clinical Research Center for Cardiovascular Surgery","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University","place":["Changsha, Hunan, China"]},{"name":"Hunan Provincial Clinical Research Center for Cardiovascular Surgery","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e41","DOI":"10.1161\/cir.0000000000001303","article-title":"2025 heart disease and stroke statistics: A report of US and global data from the American Heart Association","volume":"151","author":"Martin","year":"2025","journal-title":"Circulation"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e0001","DOI":"10.5041\/rmmj.10515","article-title":"Coronary artery surgery: Past, present, and future","volume":"15","author":"Ghandakly","year":"2024","journal-title":"Rambam Maimonides Med J"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2018.09.014","article-title":"Coronary artery bypass graft surgery complications: A review for emergency clinicians","volume":"36","author":"Montrief","year":"2018","journal-title":"Am J Emerg Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1111\/1753-0407.12970","article-title":"Atherosclerosis: Pathophysiology of insulin resistance, hyperglycemia, hyperlipidemia, and inflammation","volume":"12","author":"Beverly","year":"2020","journal-title":"J Diabetes"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e98","DOI":"10.1016\/j.diabres.2011.05.030","article-title":"TyG index performs better than HOMA in a Brazilian population: A hyperglycemic clamp validated study","volume":"93","author":"Vasques","year":"2011","journal-title":"Diabetes Res Clin Pract"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2022.102581","article-title":"Challenges in the diagnosis of insulin resistance: Focusing on the role of HOMA-IR and tryglyceride\/glucose index","volume":"16","author":"Tahapary","year":"2022","journal-title":"Diabetes Metab Syndr"},{"key":"B7","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1186\/s12933-024-02290-3","article-title":"Association of triglyceride-glucose index and its related parameters with atherosclerotic cardiovascular disease: Evidence from a 15-year follow-up of Kailuan cohort","volume":"23","author":"Xia","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1186\/s12933-023-01906-4","article-title":"Triglyceride-glucose index and coronary artery disease: A systematic review and meta-analysis of risk, severity, and prognosis","volume":"22","author":"Liang","year":"2023","journal-title":"Cardiovasc Diabetol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1186\/s12933-025-02807-4","article-title":"Association of prediabetes and insulin resistance on prognosis of patients with moderate-to-severe coronary artery calcification: A prospective cohort study","volume":"24","author":"Xie","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1186\/s12933-025-02858-7","article-title":"Association between dynamic changes in the triglyceride-glucose index and prognosis in patients with acute ST-segment elevation myocardial infarction","volume":"24","author":"Jia","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1080\/00015385.2024.2349829","article-title":"The potential of triglyceride-glucose index in improving the prediction of post-percutaneous coronary intervention clinical outcomes: A systematic review and meta-analysis","volume":"79","author":"Kohar","year":"2024","journal-title":"Acta Cardiol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.14679","article-title":"Triglyceride-glucose index's 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":"B13","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2024.1396865","article-title":"The impact of triglyceride-glucose index on the prognosis of post-PCI patients-a meta-analysis","volume":"11","author":"Wang","year":"2024","journal-title":"Front Cardiovasc Med"},{"key":"B14","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":"B15","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1186\/s12933-023-01969-3","article-title":"Triglyceride-glucose index in the prediction of adverse cardiovascular events in patients without diabetes mellitus after coronary artery bypass grafting: A multicenter retrospective cohort study","volume":"22","author":"Wu","year":"2023","journal-title":"Cardiovasc Diabetol"},{"key":"B16","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":"B17","doi-asserted-by":"publisher","DOI":"10.5551\/jat.65654","article-title":"The incremental prognostic value of incorporating the triglyceride-glucose index into the traditional cardiovascular risk factors for the long-term prognosis in ischemic cardiomyopathy patients with HFpEF following coronary artery bypass grafting: A multicenter cohort study","volume":"32","author":"Ruan","year":"2025","journal-title":"J Atheroscler Thromb"},{"key":"B18","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"B19","volume-title":"The Newcastle\u2013Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses Ottawa","author":"Wells","year":"2000"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3710","article-title":"Combination of the triglyceride-glucose index and EuroSCORE II improves the prediction of long-term adverse outcomes in patients undergoing coronary artery bypass grafting","volume":"39","author":"Wu","year":"2023","journal-title":"Diabetes Metab Res Rev"},{"key":"B22","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1186\/s12933-023-01838-z","article-title":"The synergistic effect of the triglyceride-glucose index and serum uric acid on the prediction of major adverse cardiovascular events after coronary artery bypass grafting: A multicenter retrospective cohort study","volume":"22","author":"Wu","year":"2023","journal-title":"Cardiovasc Diabetol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.1015747","article-title":"Triglyceride-glucose index in the prediction of major adverse cardiovascular events in patients with type 2 diabetes mellitus after coronary artery bypass surgery: A retrospective cohort study","volume":"13","author":"Zhang","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2025.1730404","article-title":"Additive predictive value of triglyceride-glucose index and epicardial adipose tissue volume for major adverse cardiovascular events following coronary artery bypass grafting","volume":"16","author":"Wang","year":"2026","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B25","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1186\/s12933-024-02392-y","article-title":"Diagnostic and prognostic value of triglyceride glucose index: A comprehensive evaluation of meta-analysis","volume":"23","author":"Nayak","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s12933-022-01511-x","article-title":"Triglyceride-glucose index as a marker in cardiovascular diseases: Landscape and limitations","volume":"21","author":"Tao","year":"2022","journal-title":"Cardiovasc Diabetol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1186\/s12933-022-01694-3","article-title":"Association of triglyceride-glucose index and traditional risk factors with cardiovascular disease among non-diabetic population: A 10-year prospective cohort study","volume":"21","author":"Liu","year":"2022","journal-title":"Cardiovasc Diabetol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s12933-022-01490-z","article-title":"Associations between the triglyceride-glucose index and cardiovascular disease in over 150,000 cancer survivors: A population-based cohort study","volume":"21","author":"Jung","year":"2022","journal-title":"Cardiovasc Diabetol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1186\/s12933-022-01599-1","article-title":"Association of the cumulative triglyceride-glucose index with major adverse cardiovascular events in patients with type 2 diabetes","volume":"21","author":"Tai","year":"2022","journal-title":"Cardiovasc Diabetol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-8587(24)00040-8","article-title":"Effects of statin therapy on diagnoses of new-onset diabetes and worsening glycaemia in large-scale randomised blinded statin trials: An individual participant data meta-analysis","volume":"12","year":"2024","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.4511","article-title":"Association of SGLT2 inhibitors with cardiovascular and kidney outcomes in patients with type 2 diabetes: A meta-analysis","volume":"6","author":"McGuire","year":"2021","journal-title":"JAMA Cardiol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.42078","article-title":"Association of sodium-glucose cotransporter 2 inhibitors with cardiovascular outcomes in patients with type 2 diabetes and other risk factors for cardiovascular disease: A meta-analysis","volume":"5","author":"Bhattarai","year":"2022","journal-title":"JAMA Netw Open"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-8587(21)00203-5","article-title":"Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: A systematic review and meta-analysis of randomised trials","volume":"9","author":"Sattar","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-8587(19)30249-9","article-title":"Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: A systematic review and meta-analysis of cardiovascular outcome trials","volume":"7","author":"Kristensen","year":"2019","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2003.181","article-title":"Continuous insulin infusion reduces mortality in patients with diabetes undergoing coronary artery bypass grafting","volume":"125","author":"Furnary","year":"2003","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B36","doi-asserted-by":"publisher","first-page":"ezae355","DOI":"10.1093\/ejcts\/ezae355","article-title":"2024 EACTS guidelines on perioperative medication in adult cardiac surgery","volume":"67","author":"Jeppsson","year":"2024","journal-title":"Eur J Cardiothorac Surg"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1909829\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:33:14Z","timestamp":1789101194000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1909829\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":36,"alternative-id":["10.3389\/fendo.2026.1909829"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1909829","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,11]]},"article-number":"1909829"}}