ArticleFrontiers in cardiovascular medicine2026
Prognostic value of non-insulin-based insulin resistance indices in patients with newly diagnosed coronary artery disease: a cohort study.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Aims: : Insulin resistance (IR) plays a pivotal role in the onset and progression of coronary artery disease (CAD). This study aims to assess the efficacy and clinical utility of four non-insulin-based IR indices-Triglyceride-Glucose (TyG) index, Metabolic Score for Insulin Resistance (METS-IR), Triglyceride-Glucose-Body Mass Index (TyG-BMI), and Triglyceride to High-Density Lipoprotein Cholesterol ratio (TG/HDL-C)-in predicting prognosis in patients with newly diagnosed CAD. Methods: This retrospective analysis included 890 patients with newly diagnosed CAD enrolled between January 2019 and June 2022. LASSO penalized regression was applied for covariate selection to mitigate overfitting (events-per-variable ratio ≈ 13.9), and Firth's penalized maximum likelihood estimation was performed as a sensitivity analysis. Multivariable Cox models and restricted cubic spline analyses examined associations between the four non-insulin-based IR indices and major adverse cardiovascular events (MACEs). The proportional hazards assumption was verified using Schoenfeld residual tests, and Bonferroni correction was applied for multiple comparisons ( Results: Over a median follow-up of 26.5 months, the overall incidence of MACEs was 10.9%. TyG index (HR = 1.627, 95% CI: 1.228-2.145), TyG-BMI (HR = 1.019, 95% CI: 1.014-1.023), TG/HDL-C (HR = 1.127, 95% CI: 1.055-1.195), and METS-IR (HR = 1.104, 95% CI: 1.080-1.129) were all identified as independent risk factors for MACEs. METS-IR showed the highest incremental prognostic value (C-statistic = 0.779, IDI = 0.082, NRI = 0.356, Conclusions: TyG index, TyG-BMI, TG/HDL-C ratio, and METS-IR are independently associated with MACEs in patients with newly diagnosed CAD, with METS-IR demonstrating the highest incremental predictive performance.
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