Triglyceride-glucose index in patients of coronary artery disease presenting with or without cardiovascular event.


  • Syed Ali Hamza Punjab Institute of Cardiology, Lahore
  • Ali Nasir Punjab Institute of Cardiology, Lahore
  • Fizza Mobasher Punjab Institute of Cardiology, Lahore
  • Hurmah Shoaib Punjab Institute of Cardiology, Lahore
  • Omer Aslam DHQ Hospital, Sheikhupura
  • Sana Sehar Punjab Institute of Cardiology, Lahore



Triglyceride-Glucose Index, Coronary Artery Disease, Cardiovascular Event


INTRODUCTION: Insulin resistance is a significant risk factor for coronary artery disease. A helpful surrogate test for insulin resistance is the triglyceride-glucose index, which measures how well glucose and triglycerides are metabolized. The triglyceride-glucose index, which is the combination of both indicators, has been observed to be highly connected with insulin resistance. Furthermore, it has been recommended as a viable surrogate measure of insulin resistance as a result of this significant correlation. The purpose of this research is to determine the frequency of cardiovascular event after coronary artery diseases and compare the triglyceride-glucose index in patients presenting with or without cardiovascular event after coronary artery disease.

MEYHODOLOGY: The study was conducted at the Department of Cardiology, Punjab Institute of Cardiology in Lahore from June 5, 2020 to December 5, 2020. Total 150 patients were enrolled in the study. A sterile syringe containing 5 millilitres of blood was used to withdraw the sample, and it was followed by an 8-hour period of abstinence before the sample was transported to the laboratory of the hospital for analysis of the lipid and glucose levels. Patients who had and did not have a cardiovascular incident had their reports evaluated, and the triglyceride-glucose index was determined for both groups. Statistical analysis using SPSS version 25.0 was performed on the data that was gathered. Triglyceride-glucose index was compared in patients with or without cardiovascular event by using independent samples t-test.

RESULTS: In patients having coronary artery disease, the frequency of cardiovascular events was 32, which represents 21.3%. The individuals who had a cardiovascular incident had a mean value of the triglyceride-glucose index of 9.48±0.52 and in patients of without cardiovascular event was 8.75±0.56. The level of triglyceride-glucose index was high in patients of cardiovascular event than the patients of without cardiovascular event when compared by using independent sample t-test the difference is significant (p=0.000001).

CONCLUSION: There is significant difference in triglyceride-glucose index in patients with or without cardiovascular event and the index is high in patients of cardiovascular event (p<0.05). On the basis of these results we recommend the regular screening of patients for triglyceride-glucose index in order to predict the adverse consequences after coronary artery disease.

Author Biographies

Ali Nasir, Punjab Institute of Cardiology, Lahore

Medical Officer 

Fizza Mobasher, Punjab Institute of Cardiology, Lahore

Postgraduate Resident Cardiology

Hurmah Shoaib, Punjab Institute of Cardiology, Lahore

Postgraduate Resident Cardiology

Omer Aslam, DHQ Hospital, Sheikhupura

Consultant Cardiologist

Sana Sehar, Punjab Institute of Cardiology, Lahore

Postgraduate Resident Cardiology


Donahoe SM, Stewart GC, McCabe CH, Mohanavelu S, Murphy SA, Cannon CP, et al. Diabetes and Mortality Following Acute Coronary Syndromes. JAMA. 2007;298(7):765-75.

Jellinger PS, Handelsman Y, Rosenblit PD, Bloomgarden ZT, Fonseca VA, Garber AJ, et al. American Association of Clinical Endocrinologists and American College of Endocrinology guidelines for management of dyslipidemia and prevention of cardiovascular disease. Endocrine Practice. 2017;23(2):1-87.

Zhou M, Liu J, Hao Y, Liu J, Huo Y, Smith SC, et al. Prevalence and in-hospital outcomes of diabetes among patients with acute coronary syndrome in China: findings from the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome Project. Cardiovascular Diabetology. 2018;17(1):147.

Meikle PJ, Wong G, Barlow CK, Kingwell BA. Lipidomics: potential role in risk prediction and therapeutic monitoring for diabetes and cardiovascular disease. Pharmacology & therapeutics. 2014;143(1):12-23.

Alshehry ZH, Mundra PA, Barlow CK, Mellett NA, Wong G, McConville MJ, et al. Plasma lipidomic profiles improve on traditional risk factors for the prediction of cardiovascular events in type 2 diabetes mellitus. Circulation. 2016;134(21):1637-50.

Meikle PJ, Formosa MF, Mellett NA, Jayawardana KS, Giles C, Bertovic DA, et al. HDL Phospholipids, but Not Cholesterol Distinguish Acute Coronary Syndrome From Stable Coronary Artery Disease. J Am Heart Assoc 2019;8(11):e011792.

Won KB, Kim YS, Lee BK, Heo R, Han D, Lee JH, et al. The relationship of insulin resistance estimated by triglyceride glucose index and coronary plaque characteristics. Medicine. 2018;97(21):e10726.

Navarro-González D, Sánchez-Íñigo L, Pastrana-Delgado J, Fernández-Montero A, Martinez JA. Triglyceride–glucose index (TyG index) in comparison with fasting plasma glucose improved diabetes prediction in patients with normal fasting glucose: the vascular- metabolic CUN cohort. Preventive medicine. 2016;86:99-105.

Moon S, Park J-S, Ahn Y. The cut-off values of triglycerides and glucose index for metabolic syndrome in American and Korean adolescents. Journal of Korean medical science. 2017;32(3):427-33.

Zhang M, Wang B, Liu Y, Sun X, Luo X, Wang C, et al. Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: the rural Chinese cohort study. Cardiovascular diabetology. 2017;16(1):30.

Mao Q, Zhou D, Li Y, Wang Y, Xu S-C, Zhao X-H. The Triglyceride-Glucose Index Predicts Coronary Artery Disease Severity and Cardiovascular Outcomes in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome. Dis Markers 2019;2019:6891537-.

Jin JL, Cao YX, Wu LG, You XD, Guo YL, Wu NQ, et al. Triglyceride glucose index for predicting cardiovascular outcomes in patients with coronary artery disease. J Thorac Dis. 2018;10(11):6137-46.

Sánchez?Íñigo L, Navarro?González D, Fernández?Montero A, Pastrana?Delgado J, Martínez JA. The TyG index may predict the development of cardiovascular events. European Journal of Clinical Investigation. 2016;46(2):189-97.

Simental-Mendía LE, Hernández-Ronquillo G, Gómez-Díaz R, Rodríguez-Morán M, Guerrero-Romero F. The triglycerides and glucose index is associated with cardiovascular risk factors in normal-weight children and adolescents. Pediatric Research. 2017;82(6):920-5.

Irace C, Carallo C, Scavelli F, De Franceschi M, Esposito T, Tripolino C, et al. Markers of insulin resistance and carotid atherosclerosis. A comparison of the homeostasis model assessment and triglyceride glucose index. International Journal of Clinical Practice. 2013;67(7):665-72.

Kim MK, Ahn CW, Kang S, Nam JS, Kim KR, Park JS. Relationship between the triglyceride glucose index and coronary artery calcification in Korean adults. Cardiovascular diabetology. 2017;16(1):108.

Lee EY, Yang HK, Lee J, Kang B, Yang Y, Lee SH, et al. Triglyceride glucose index, a marker of insulin resistance, is associated with coronary artery stenosis in asymptomatic subjects with type 2 diabetes. Lipids in health and disease. 2016;15(1):1-7.

Vega GL, Barlow CE, Grundy SM, Leonard D, DeFina LF. Triglyceride–to–high-density-lipoprotein-cholesterol ratio is an index of heart disease mortality and of incidence of type 2 diabetes mellitus in men. Journal of Investigative Medicine. 2014;62(2):345-9.

Budoff M. Triglycerides and triglyceride-rich lipoproteins in the causal pathway of cardiovascular disease. Am J Cardiol. 2016;118(1):138-45.