Objective:

To investigate the relationship between the triglyceride-glucose (TyG) index and 2-year major adverse cardiovascular events (MACE) in individuals with hypertension and obstructive coronary artery disease (OCAD).

Approach:

• Study Design: A retrospective cohort study was conducted with 1,024 individuals diagnosed with essential hypertension and OCAD.
• Data Analysis: Logistic regression, restricted cubic splines (RCS), subgroup analysis, and interaction testing were used to evaluate the correlation between the TyG index and MACE risk.
• Causal Inference: Mendelian randomization (MR) analysis was employed to assess the causal relationship between the TyG index and adverse cardiovascular outcomes.

Key Findings:

• 19.73% of patients experienced MACE after a 2-year follow-up.
• Each one-unit increment in the TyG index was associated with a 45.2% increased risk of MACE (odds ratio: 1.452, 95% confidence intervals 1.101–1.913; P = 0.008).
• The TyG index showed consistent predictive performance across different subgroups.
• A significant positive linear association between the TyG index and MACE was confirmed by RCS analysis.
• MR analysis indicated a significant causal relationship between elevated TyG index levels and adverse cardiovascular outcomes.

Interpretation:

Elevated TyG index levels are linked to worse clinical outcomes in individuals with hypertension and OCAD.

Limitations:

• The study was limited to a single hospital setting, which may affect generalizability.
• The cohort consisted of individuals with specific inclusion criteria, potentially limiting the applicability to broader populations.

Conclusion:

The findings indicate that the TyG index is associated with cardiovascular outcomes in patients with hypertension and OCAD.