Higher Triglyceride-glucose index increases MACE risk in patients undergoing coronary artery bypass graftingHigher Triglyceride-Glucose Index Linked to Risks After Heart Surgery

Frontiers in Medicine Published September 11, 2026 DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Note that a higher TyG index is associated with increased MACE risk in patients following coronary artery bypass grafting.

This meta-analysis evaluated the association between the Triglyceride-glucose index (TyG) and clinical outcomes in 5,978 patients undergoing coronary artery bypass grafting (CABG). The analysis focused on the TyG index as a surrogate marker of insulin resistance to assess risk for major adverse cardiovascular events (MACE) and other secondary outcomes.

Key findings indicate that a 1-unit increase in TyG is associated with a 62.4% higher hazard of MACE (95% CI: 1.349-1.955). Patients in the highest TyG tertile showed a statistically higher hazard of MACE compared to the lowest tertile (95% CI: 1.635-2.680). Additionally, a higher TyG group demonstrated higher odds of MACE compared to a lower TyG group (95% CI: 1.97-3.40). While all-cause mortality, nonfatal stroke, and nonfatal myocardial infarction were associated with higher risk in higher TyG groups, no association was found for revascularization.

The authors note that the TyG index may serve as an accessible supplementary metabolic risk marker following CABG. However, they caution that further prospective validation is required before the index can be routinely applied to individual risk prediction. The association is noted as a surrogate marker of insulin resistance rather than a direct causal link.

How this fits prior evidence

This finding addresses a gap in identifying accessible metabolic risk markers following coronary artery bypass grafting. While previous coverage has focused on procedural techniques like near-styloid puncture and pharmacological management such as clopidogrel monotherapy or DAPT de-escalation, this meta-analysis provides a metabolic metric (TyG index) to potentially identify patients at higher risk for MACE. It complements existing evidence on MACE reduction by providing a non-invasive surrogate marker for insulin resistance.

Researchers analyzed data from nearly 6,000 patients who underwent coronary artery bypass grafting (CABG) to understand how certain metabolic markers affect recovery. They specifically looked at the triglyceride-glucose index (TyG), which is used as a marker for insulin resistance.

The study found that patients with a higher TyG index had a significantly higher risk of major adverse cardiovascular events. This included a higher risk of death from any cause, nonfatal strokes, and nonfatal heart attacks. Specifically, a higher TyG score was associated with a 62.4% higher hazard of these major events.

While the TyG index may be a useful tool for doctors to track metabolic risk after surgery, it is not a perfect predictor for every individual. Because this was a meta-analysis of existing data, more direct studies are needed before it can be used as a standard tool for individual risk prediction. Patients should discuss these findings with their doctors to understand how their specific levels impact their long-term heart health.

What this means for you:

Higher triglyceride-glucose levels are linked to more serious heart complications after bypass surgery.

Common questions

What is the TyG index and why does it matter?

The triglyceride-glucose index (TyG) is a marker used to measure insulin resistance. In this study of 5,978 patients, a higher TyG index was linked to a 62.4% higher hazard of major cardiovascular events. It may serve as a helpful way for doctors to track metabolic risk after heart bypass surgery.

What specific risks were linked to a higher TyG index?

Patients with a higher TyG index showed a higher risk of several serious conditions, including all-cause mortality, nonfatal stroke, and nonfatal myocardial infarction. The study found that those in the highest TyG group had a statistically higher hazard of these major cardiovascular events compared to those in the lowest group.

Can the TyG index be used to predict my personal risk?

The TyG index may be a helpful tool for doctors to assess metabolic risk, but it is not a definitive predictor for every individual. Because the evidence is based on a meta-analysis, more prospective studies are needed before it can be used as a standard tool for individual risk prediction. Talk to your doctor about your specific results.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedSep 2026

View Original Abstract ↓

AimsTo evaluate the prognostic value of the triglyceride–glucose index (TyG), a surrogate marker of insulin resistance, for adverse cardiovascular outcomes in patients undergoing coronary artery bypass grafting (CABG).Materials and methodsThis 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.ResultsSix 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 = 2.093, 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.ConclusionThe 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.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251158075

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