The Triglyceride-Glucose Index: A Clinical Tool to Quantify Insulin Resistance as a Metabolic Myocardial Remodeling...

Atrial fibrillation (AF) is the most common arrhythmia worldwide, a major cause of heart failure and stroke, and carries a significant healthcare burden. Atrial cardiomyopathy (ACM) provides the structural and electrophysiological basis for AF, while metabolic dysregulation, particularly insulin resistance (IR), is increasingly recognized as a key factor exacerbating atrial remodeling. However, due to the complexity and high cost of IR measurement procedures, no reliable, user-friendly, and practical tool supporting AF risk stratification has yet been identified in clinical practice. To address this gap, we conducted a literature search in various databases and found an increasing body of research indicating that the triglyceride-glucose index (TyG index) is a simpler, more cost-effective alternative for identifying adverse metabolic profiles and the AF risk. This narrative review describes the existing literature and explores the potential mechanisms underlying changes in the TyG index and its clinical applications, while also discussing the challenges facing the use of this index and future research directions. In summary, the current evidence suggests that the TyG index is a promising but not yet established risk assessment biomarker for AF.