Triglyceride-Glucose Index and Fatty Acids Impact CAD Outcomes

Background: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality globally, with obesity being a major risk factor. High triglyceride levels and free fatty acids have been implicated in worsening CAD outcomes, yet the specific role of the triglyceride-glucose index in predicting cardiovascular events in this population is not well understood.

Method: This study utilized a multicenter observational cohort design involving 500 obese patients diagnosed with CAD. Inclusion criteria were individuals aged 40-70 years with a BMI ≥30. The primary endpoint was the incidence of major adverse cardiovascular events (MACE), defined as cardiovascular death, myocardial infarction, and stroke, assessed over a 5-year follow-up. Statistical analyses included Cox proportional hazards models adjusting for potential confounders.

Results: A higher triglyceride-glucose index (TGI) was associated with an increased risk of MACE, with a hazard ratio of 1.8 (95% CI 1.2-2.6, P=0.002) for each standard deviation increase in TGI. Additionally, elevated free fatty acid levels correlated with a 30% increase in cardiovascular events, which was statistically significant (P<0.001). Safety data revealed that 5% of participants experienced adverse events related to treatment.

Conclusion: The findings indicate that both the triglyceride-glucose index and free fatty acid levels have significant prognostic value in obese patients with CAD, supporting their integration into risk stratification protocols. These results highlight the need for targeted metabolic interventions in this high-risk population; however, due to the observational nature of the study, causal inferences should be made with caution.

Original citation address: https://www.besjournal.com/en/article/doi/10.3967/bes2026.015