ArticleCardiovascular diabetology2023
The synergistic effect of the triglyceride-glucose index and serum uric acid on the prediction of major adverse cardiovascular events after coronary artery bypass grafting: a multicenter retrospective cohort study.
Article in Cardiovascular diabetology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Triglyceride-glucose index as a novel predictor of major adverse cardiovascular events in patients with coronary revascularization: a meta-analysis of cohort studies.Annals of medicine · 2026Pooled it
- Triglyceride-glucose index as a metabolic risk marker for adverse outcomes after coronary artery bypass grafting: a systematic review and meta-analysis.Frontiers in endocrinology · 2026Pooled it
- Uric Acid and Uric Acid Index in Predicting Coronary Artery Disease, Cerebrovascular Events, and Mortality: A Sex-Stratified Cohort Study.Clinical cardiology · 2026Article
- Association of hyperuricemia and a three-component lifestyle score with elevated cardiometabolic risk: a health-examination-based cross-sectional study.Frontiers in endocrinology · 2026Article
- The triglyceride-glucose index and acute kidney injury risk in critically ill patients with coronary artery disease.Renal failure · 2025Article
- Gender differences in the predictive value of serum uric acid for major adverse cardiovascular events in patients with acute coronary syndromes: a retrospective cohort study.BMC cardiovascular disorders · 2025Article
- The joint effect of triglyceride-glucose index and C-reactive protein levels on the risk of chronic obstructive pulmonary disease: a prospective cohort study.Lipids in health and disease · 2025Article
- Association between triglyceride-glucose-body mass index and adverse prognosis in elderly patients with severe heart failure and type 2 diabetes: a retrospective study based on the MIMIC-IV database.Cardiovascular diabetology · 2025Article
- Association between triglyceride glucose index and adverse cardiovascular prognosis in patients with atrial fibrillation without diabetes: a retrospective cohort study.Lipids in health and disease · 2025Article
- Combining triglyceride glucose-body mass index and high-sensitivity C-reactive protein to predict cardiovascular disease: results from a national cohort and a clinical verified cohort.Frontiers in cardiovascular medicine · 2025Article
- The association between pancreatic diseases and pancreatic fat content: a cross-sectional study from the UK Biobank.Frontiers in endocrinology · 2025Article
- The Impact of Triglyceride-Glucose Index Trajectories on Incidence and Recurrent Cardiovascular Events: Evidence from a Retrospective Cohort Study.Vascular health and risk management · 2025Article
- The role of insulin resistance in the relationship between uric acid and the severity of coronary artery disease: evidence from real-world data.Frontiers in nutrition · 2025Article
- Changes in the estimated glucose disposal rate and incident cardiovascular disease: two large prospective cohorts in Europe and Asia.Cardiovascular diabetology · 2024Article
- Evaluating the impact of chronic kidney disease and the triglyceride-glucose index on cardiovascular disease: mediation analysis in the NHANES.BMC public health · 2024Article
- An overview of the application and potential mechanism on the triglyceride glucose index with multi-vessel coronary disease.Lipids in health and disease · 2024Review
- Interpretable machine learning framework to predict gout associated with dietary fiber and triglyceride-glucose index.Nutrition & metabolism · 2024Article
- The association of perioperative serum uric acid variation with in-hospital adverse outcomes in coronary artery bypass grafting patients.Frontiers in cardiovascular medicine · 2024Article
- The impact of statin use on short-term and long-term mortality in patients with heart failure.Frontiers in pharmacology · 2024Article
- Prognostic value of triglyceride-glucose index in patients with chronic coronary syndrome undergoing percutaneous coronary intervention.Cardiovascular diabetology · 2023Article
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundElevated serum uric acid (SUA) is regarded as a risk factor for the development of cardiovascular diseases. Triglyceride-glucose (TyG) index, a novel surrogate for insulin resistance (IR), has been proven to be an independent predictor for adverse cardiac events. However, no study has specifically focused on the interaction between the two metabolic risk factors. Whether combining the TyG index and SUA could achieve more accurate prognostic prediction in patients undergoing coronary artery bypass grafting (CABG) remains unknown.
methodsThis was a multicenter, retrospective cohort study. A total of 1225 patients who underwent CABG were included in the final analysis. The patients were grouped based on the cut-off value of the TyG index and the sex-specific criteria of hyperuricemia (HUA). Cox regression analysis was conducted. The interaction between the TyG index and SUA was estimated using relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (SI). The improvement of model performance yielded by the inclusion of the TyG index and SUA was examined by C-statistics, net reclassification improvement (NRI) and integrated discrimination improvement (IDI). The goodness-of-fit of models was evaluated using the Akaike information criterion (AIC), Bayesian information criterion (BIC) and χ
resultsDuring follow-up, 263 patients developed major adverse cardiovascular events (MACE). The independent and joint associations of the TyG index and SUA with adverse events were significant. Patients with higher TyG index and HUA were at higher risk of MACE (Kaplan-Meier analysis: log-rank P < 0.001; Cox regression: HR = 4.10; 95% CI 2.80-6.00, P < 0.001). A significant synergistic interaction was found between the TyG index and SUA [RERI (95% CI): 1.83 (0.32-3.34), P = 0.017; AP (95% CI): 0.41 (0.17-0.66), P = 0.001; SI (95% CI): 2.13 (1.13-4.00), P = 0.019]. The addition of the TyG index and SUA yielded a significant improvement in prognostic prediction and model fit [change in C-statistic: 0.038, P < 0.001; continuous NRI (95% CI): 0.336 (0.201-0.471), P < 0.001; IDI (95% CI): 0.031 (0.019-0.044), P < 0.001; AIC: 3534.29; BIC: 3616.45; likelihood ratio test: P < 0.001).
conclusionsThe TyG index interacts synergistically with SUA to increase the risk of MACE in patients undergoing CABG, which emphasizes the need to use both measures concurrently when assessing cardiovascular risk.
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