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Meta-Analysis
. 2025 Jul 24:16:1463647.
doi: 10.3389/fendo.2025.1463647. eCollection 2025.

A meta-analysis of the prognostic value of the TyG index in heart failure

Yuqin Cai  1 , Meijie Yang  1 , Shuting Ma  1 , Jinyun Zhang  1 , Bin Huang  2 , Baili Yu  2
Affiliations
Meta-Analysis

A meta-analysis of the prognostic value of the TyG index in heart failure

Yuqin Cai et al. Front Endocrinol (Lausanne). .

Abstract

Background: Heart failure (HF) is a serious cardiovascular disorder with a poor prognosis, which affects the quality of life and survival in patients. The triglyceride-glucose (TyG) index, a new biomarker for insulin resistance (IR) in the body, has attracted widespread attention from researchers investigating cardiovascular disease (CVD). This study was aimed at assessing the prognostic value of the TyG index in HF patients by a meta-analysis, thereby providing clinicians with a new predictive tool.

Methods: PubMed, Cochrane, EMBASE, and Web of Science were searched for studies (from inception to March 2025) on the association of the TyG index with the prognosis of HF. Meta-analysis was conducted using Stata15. Such association was assessed using a random effects model in conjunction with the hazard ratio (HR) and its 95% confidence interval (CI). In addition, subgroup analysis, publication bias analysis, and sensitivity analysis were performed.

Results: Nineteen studies were included with 44275 HF patients. A significant association was found between an increase in the TyG index and an increase in the risk of all-cause death (ACD) in HF patients (HR=1.70, 95% CI: 1.40-2.08, P<0.001). Increased TyG index predicted major adverse cardiovascular events (MACEs) (HR=2.37, 95% CI: 1.80-3.13, P<0.001) and cardiovascular death (CV death) (HR=1.63, 95% CI: 1.01-2.61, P<0.001). Subgroup analysis showed an association of increased TyG index with a poor prognosis regardless of ejection fraction, and the presence or absence of diabetes. Dose-response analysis showed no linear dose-response relationship (DRR) of the index with ACD, MACEs or CV death.

Conclusion: The TyG index is closely associated with the prognosis of HF. Therefore, it can be used as a prognostic tool for the assessment of HF. A high TyG index may indicate a high risk of ACD and CV events. Therefore, monitoring of the TyG index is significant for risk assessment and management of HF patients. Future studies on the use of the TyG index in therapeutic decision-making for HF are needed.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024562063.

Keywords: TyG index; cardiovascular disease; heart failure; meta-analysis; prognosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Process of study selection.
Figure 2
Figure 2
Forest plot of the effect of this index on ACD [(A) Categorical variables; (B) Continuous variables].
Figure 3
Figure 3
Forest plot of the effect of this index on MACEs [(A) Categorical variables; (B) Continuous variables].
Figure 4
Figure 4
Forest plot of the effect of this index on CV death [(A) Categorical variables; (B) Continuous variables].
Figure 5
Figure 5
DRR between this index and HF outcome measures [(A) ACD; (B) MACEs; (C) CV death].
Figure 6
Figure 6
Sensitivity analyses [(A, B) All-cause death; (C, D) MACEs; (E, F) CV death; (A, C, E) Categorical variables; (B, D, F) Continuous variables].
Figure 7
Figure 7
Publication bias ((A) Categorical variables of all-cause death; (B) Continuous variables of All-cause death; (C) Categorical variables of MACEs; (D) Categorical variables of CV death).
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References

    1. James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. (2018) 392:1789–858. doi: 10.1016/S0140-6736(18)32279-7, PMID: - DOI - PMC - PubMed
    1. Chandra A, Vaduganathan M, Lewis EF, Claggett BL, Rizkala AR, Wang W, et al. Health-related quality of life in heart failure with preserved ejection fraction: the PARAGON-HF trial. JACC Heart Fail. (2019) 7:862–74. doi: 10.1016/j.jchf.2019.05.015, PMID: - DOI - PubMed
    1. Ma LY, Chen WW, Gao RL, Liu LS, Zhu ML, Wang YJ, et al. China cardiovascular diseases report 2018: an updated summary. J Geriatr Cardiol. (2020) 17:1–8. doi: 10.11909/j.issn.1671-5411.2020.01.001, PMID: - DOI - PMC - PubMed
    1. Gager GM, Gelbenegger G, Jilma B, von Lewinski D, Sourij H, Eyileten C, et al. Cardiovascular outcome in patients treated with SGLT2 inhibitors for heart failure: A meta-analysis. Front Cardiovasc Med. (2021) 8:691907. doi: 10.3389/fcvm.2021.691907, PMID: - DOI - PMC - PubMed
    1. Banović MD, Ristić AD. The role of mitochondrial dysfunction in heart failure and potential therapeutic targets. Curr Pharm Des. (2016) 22:4752–62. doi: 10.2174/1381612822666160614081853, PMID: - DOI - PubMed