Background: The Triglyceride-Glucose (TyG) index is a composite measure derived from fasting triglycerides and fasting glucose levels, calculated using the formula Ln [fasting triglyceride level (mg/dL) × fasting glucose level (mg/dL)/2]. Introduced in 2008 as a simple and cost-effective biomarker, the TyG index was initially used to identify insulin resistance. Given the close relationship between insulin resistance and cardiovascular diseases, numerous studies have explored the correlation between the TyG index and cardiovascular diseases. Recent research indicates that the TyG index is an independent predictor of various cardiovascular events and adverse outcomes, highlighting its potential in predicting cardiovascular risk.

Objective: There is a lack of evidence on whether the TyG index can predict adverse outcomes in patients with coronary heart disease and hypertension. This study aimed to explore whether the TyG index has predictive value for major adverse events in these patients.

Overview: The study by Dr. Liu Yahui and colleagues was a single-center, prospective, observational clinical study that included 1,467 patients aged 18-75 diagnosed with coronary heart disease and hypertension. All patients were followed for one year, with the primary endpoint defined as the occurrence of all-cause mortality or non-fatal cardiovascular events within one year. Patients were divided into three groups (T1, T2, T3) based on TyG index tertiles. The results showed that patients with higher TyG indices had a higher proportion of adverse events (T3 vs T1=15.0% vs 6.9%). Moreover, after adjusting for various confounding factors, the TyG index, whether as a categorical or continuous variable, was significantly associated with the risk of adverse cardiovascular events in these patients. As a continuous variable, there was a significant dose-response relationship (non-linear P=0.632) between the TyG index and the risk of adverse events; each standard deviation increases in the TyG index was associated with a 28% increase in the risk of major endpoint events [HR=1.28, 95% CI:1.04-1.59]. In summary, the TyG index can serve as an independent predictor of adverse cardiovascular outcomes in patients with coronary heart disease and hypertension.

Commentary: In 2023, the Chinese lipid guidelines highlighted that LDL-c is a crucial therapeutic target for patients with coronary heart disease (CHD) and also emphasized that for high-risk ASCVD patients whose triglyceride (TG) levels remain elevated despite statin therapy, adding high-purity eicosapentaenoic acid (EPA), high-purity ω-3 fatty acids, or fibrates could help reduce ASCVD risk. The advantages of TG and TyG, such as ease of acquisition and low cost, have made them increasingly popular among researchers. Numerous studies have shown that the TyG index can predict the occurrence of various diseases, including diabetes, hypertension, coronary heart disease, and ischemic stroke, as well as their adverse clinical outcomes. Research by Dr. Liu Yahui and colleagues was the first to demonstrate that the TyG index, independent of traditional risk factors, can also serve as a predictor of adverse cardiovascular events in patients with coronary heart disease and hypertension. This suggests that, for patients with both coronary heart disease and hypertension, regardless of whether they have diabetes, it is important to not only strengthen the control of traditional risk factors such as blood pressure and blood lipids but also to closely monitor the dynamic changes in the TyG index to potentially improve long-term outcomes. As a promising biomarker for assessing insulin resistance and cardiovascular disease risk, the TyG index holds significant potential value in cardiovascular risk assessment and management. This research provides a theoretical basis and practical experience for further clinical interventions targeting TG.