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Predictive Value of the Triglyceride-Glucose Index (TyG Index) for Major Cardiac Events in Patients With Chronic

Md Fakhrul Hasan1, Manzoor Mahmood2, Mohmmad D Selim3

  • 1Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, BGD.

Cureus
|March 13, 2026
PubMed

Insights

The triglyceride-glucose (TyG) index effectively predicts major adverse cardiac events (MACEs) in patients with chronic heart failure and type 2 diabetes. This simple marker aids risk stratification in clinical practice.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Syndrome

Background:

  • Coexisting chronic heart failure (CHF) and type 2 diabetes mellitus (T2DM) significantly increase the risk of major adverse cardiac events (MACEs).
  • Insulin resistance is a key factor in this elevated risk, but its direct assessment is challenging in routine clinical settings.
  • The triglyceride-glucose (TyG) index, calculated from fasting glucose and triglyceride levels, serves as a practical surrogate marker for insulin resistance.

Purpose of the Study:

  • To evaluate the predictive capability of the triglyceride-glucose (TyG) index for MACE in patients diagnosed with both CHF and T2DM.
  • To assess the TyG index's utility as a prognostic tool in this high-risk patient population.

Main Methods:

  • A prospective observational study involving 83 adult patients with confirmed CHF and T2DM over a six-month follow-up period.
  • Calculation of the TyG index using fasting glucose and triglyceride levels.
  • Adjudication of MACEs (cardiovascular death, heart-failure hospitalization, ischemic events) by blinded cardiologists.
  • Statistical analyses including group comparisons, quartile analysis, and receiver operating characteristic (ROC) curve analysis.

Main Results:

  • A high incidence of MACEs (83.1%) was observed, primarily driven by heart-failure-related hospitalizations (80.7%).
  • Patients experiencing MACEs exhibited significantly higher TyG index values compared to those without MACEs (6.8 ± 0.7 vs. 5.8 ± 0.6; p=0.001).
  • Higher quartiles of the TyG index were significantly associated with increased mortality and heart-failure hospitalization (p<0.05).
  • ROC analysis revealed excellent predictive accuracy for MACE (AUC=0.890), with an optimal cutoff of ≥6.30.

Conclusions:

  • The triglyceride-glucose (TyG) index demonstrates strong predictive value for MACE in patients with concurrent CHF and T2DM.
  • The TyG index's simplicity and accessibility make it a valuable tool for routine risk stratification, especially in resource-limited environments.
  • Integrating the TyG index into clinical practice can improve prognostic assessment for this vulnerable patient group.
Abstract

Keywords:
heart failureinsulin resistancemajor adverse cardiac eventsprognosistriglyceride glucose indextype 2 diabetes mellitus

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