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A meta-analysis of the prognostic value of the TyG index in heart failure
Yuqin Cai1, Meijie Yang1, Shuting Ma1
1School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Insights
The triglyceride-glucose (TyG) index is a significant predictor of poor outcomes in heart failure (HF) patients. Monitoring this biomarker can aid in risk assessment and management for individuals with HF.
Area of Science:
- Cardiology
- Metabolic Syndrome
- Biomarkers
Background:
- Heart failure (HF) is a debilitating cardiovascular disease impacting patient quality of life and survival.
- The triglyceride-glucose (TyG) index, a marker of insulin resistance, is gaining attention in cardiovascular disease research.
Purpose of the Study:
- To assess the prognostic value of the TyG index in patients with heart failure.
- To evaluate the TyG index as a potential predictive tool for clinicians managing HF patients.
Main Methods:
- A comprehensive meta-analysis was performed on 19 studies involving 44,275 HF patients.
- Searches were conducted across PubMed, Cochrane, EMBASE, and Web of Science up to March 2025.
- Random effects models were used to analyze hazard ratios and confidence intervals, with subgroup and sensitivity analyses.
Main Results:
- An elevated TyG index was significantly associated with increased risk of all-cause death (HR=1.70) and major adverse cardiovascular events (HR=2.37) in HF patients.
- The TyG index predicted cardiovascular death (HR=1.63) and poor prognosis irrespective of ejection fraction or diabetes status.
- No linear dose-response relationship was observed between the TyG index and adverse outcomes.
Conclusions:
- The TyG index demonstrates a strong association with prognosis in heart failure patients.
- A high TyG index serves as an indicator for elevated risk of all-cause death and cardiovascular events.
- Monitoring the TyG index is crucial for risk stratification and management strategies in HF patients.
Background:
Heart failure (HF) is a serious cardiovascular disorder with a poor prognosis, which affects the quality of life and survival in patients. The triglyceride-glucose (TyG) index, a new biomarker for insulin resistance (IR) in the body, has attracted widespread attention from researchers investigating cardiovascular disease (CVD). This study was aimed at assessing the prognostic value of the TyG index in HF patients by a meta-analysis, thereby providing clinicians with a new predictive tool.
Methods:
PubMed, Cochrane, EMBASE, and Web of Science were searched for studies (from inception to March 2025) on the association of the TyG index with the prognosis of HF. Meta-analysis was conducted using Stata15. Such association was assessed using a random effects model in conjunction with the hazard ratio (HR) and its 95% confidence interval (CI). In addition, subgroup analysis, publication bias analysis, and sensitivity analysis were performed.
Results:
Nineteen studies were included with 44275 HF patients. A significant association was found between an increase in the TyG index and an increase in the risk of all-cause death (ACD) in HF patients (HR=1.70, 95% CI: 1.40-2.08, P<0.001). Increased TyG index predicted major adverse cardiovascular events (MACEs) (HR=2.37, 95% CI: 1.80-3.13, P<0.001) and cardiovascular death (CV death) (HR=1.63, 95% CI: 1.01-2.61, P<0.001). Subgroup analysis showed an association of increased TyG index with a poor prognosis regardless of ejection fraction, and the presence or absence of diabetes. Dose-response analysis showed no linear dose-response relationship (DRR) of the index with ACD, MACEs or CV death.
Conclusion:
The TyG index is closely associated with the prognosis of HF. Therefore, it can be used as a prognostic tool for the assessment of HF. A high TyG index may indicate a high risk of ACD and CV events. Therefore, monitoring of the TyG index is significant for risk assessment and management of HF patients. Future studies on the use of the TyG index in therapeutic decision-making for HF are needed.
Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024562063.
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