Prognostic role of triglyceride-glucose index and triglyceride-glucose body mass index in patients undergoing coronary artery bypass grafting: a systematic review and meta-analysis.

BACKGROUND: The prognostic role of triglyceride-glucose (TyG) index and triglyceride-glucose body mass index (TyG-BMI) in patients undergoing coronary artery bypass grafting (CABG) remains unclear. This meta-analysis aimed to clarify prognostic value of TyG index and TyG-BMI among patients undergoing CABG. METHODS: Several databases were searched up to May 20, 2026. Primary prognostic outcomes included major adverse cardiovascular event (MACE) and major adverse cardiovascular and cerebrovascular event (MACCE). Secondary outcomes included all-cause mortality, cardiac mortality, nonfatal myocardial infarction (MI), nonfatal stroke, acute kidney injury (AKI), atrial fibrillation (AF), symptomatic graft failure (SGF) and cerebral infarction. RESULTS: Fifteen studies with 16,185 cases were enrolled. The results demonstrated that elevated TyG index was related to increased risk of MACE [odds ratio (OR) =1.91, P<0.001] and MACCE (OR =1.67, P<0.001). Subgroup analysis indicated more significant association between TyG index and risk of MACE (OR =4.27, P=0.001) and MACCE (OR =1.71, P<0.001) among diabetic patients. Besides, TyG index was associated with the risk of all-cause mortality [hazard ratio (HR) =1.37, P=0.02], cardiac mortality (HR =2.59, P=0.001), nonfatal MI (OR =2.02, P=0.04), nonfatal stroke (OR =2.00, P<0.001), AF (OR =1.55, P<0.001), SGF (OR =2.987, P=0.003) and cerebral infarction (OR =1.93, P<0.001). Furthermore, elevated TyG-BMI was related to increased incidence of AKI (OR =1.03, P<0.001) among diabetic patients. CONCLUSIONS: Preoperative elevated TyG index was associated with worse clinical outcomes such as increased incidence of MACE and MACCE in patients undergoing CABG, especially among diabetes mellitus (DM) patients. Besides, higher TyG-BMI index indicated increased risk of AKI in diabetic patients.