The potential of triglyceride-glucose index in improving the prediction of post-percutaneous coronary intervention clinical outcomes: a systematic review and meta-analysis

• Published in: Acta cardiologica Vol. 79; no. 5; p. 557
• Main Authors: Kohar, Kelvin, Sanjaya, Indira Saraswati, Amirah, Shakira, Yumnanisha, Defin Allevia, Ambari, Ade Meidian
• Format: Journal Article
• Language: English
• Published: England 01.07.2024
• Subjects: Acute Coronary Syndrome - blood; Acute Coronary Syndrome - diagnosis; Acute Coronary Syndrome - therapy; Biomarkers - blood; Blood Glucose - analysis; Blood Glucose - metabolism; Humans; Percutaneous Coronary Intervention - methods; Predictive Value of Tests; Risk Assessment - methods; Risk Factors; Treatment Outcome; Triglycerides - blood; Triglyceride-glucose index; percutaneous coronary intervention; prediction model; major adverse cardiovascular effect
• ISSN: 1784-973X
• DOI: 10.1080/00015385.2024.2349829

Despite percutaneous coronary intervention is the current preferred reperfusion modality, the incidence of major adverse cardiovascular events (MACE) is still high. Currently, GRACE score is used for predicting PCI outcomes. The TyG (triglyceride-glucose) index, a potential predictor based on insulin resistance of cardiovascular disease, has not been considered in the GRACE score. To assess the potential of the TyG index in predicting cardiovascular adverse clinical outcomes in patients undergoing PCI. Following PRISMA guidelines, the authors reviewed literature from five databases. We included studies investigating post-PCI outcomes based on the TyG index level. Effect size was estimated using RevMan to calculate pooled odds ratio and mean difference, and R software to perform diagnostic test accuracy. Overall, 31,671 post-PCI patients with acute coronary syndrome were included in this study. A significant difference in TyG index was found between patients who experienced MACE and those who did not [MD: 0.3 (0.2-0.4),  < .05]. Higher TyG index was strongly correlated with higher MACE [OR: 2.01 (1.45-2.77),  < .05], especially revascularization [OR: 2.40 (1.72-3.36),  < .05], followed by myocardial infarction [OR: 1.80 (2.41-2.86),  < .05], death [OR: 1.36 (0.86-2.15),  = .19], and stroke [OR: 1.09 (0.79-1.50),  = .59]. Tyg Index showed 55% sensitivity, 60% specificity, and 0.612 accuracy. The addition of the TyG index to the GRACE scoring improved the predictive model's AUC (0.746 vs. 0.809). This systematic review and meta-analysis comprises evidence-based results for the correlation of TyG index and post-PCI outcomes, demonstrating modest sensitivity, specificity, accuracy, and enhanced predictive value of GRACE score.