Joint Impact of Triglyceride-glucose Index and Free Fatty Acid Levels on Cardiovascular Outcomes in Overweight or Obese Patients with Coronary Artery Disease - A Large Multicenter Prospective Study.

Authors

Que Yun Sun, Cheng Cui, Wei Ting Cai, Lin Jiang, Jing Jing Xu, Yi Yao, Na Xu, Xiao Zeng Wang, Zhen Yu Liu, Zheng Zhang, Yong Zhen Zhang, Xiao Gang Guo, Zhi Fang Wang, Ying Qing Feng, Qing Sheng Wang, Jian Xin Li, Xue Yan Zhao, Jue Chen, Run Lin Gao, Lei Song, Ya Ling Han, Jin Qing Yuan, Ying Song

Published in

Biomedical and environmental sciences : BES. Volume 39. Issue 6. Pages 630-640. Jun 20, 2026.

Abstract

To investigate the joint effect of free fatty acid (FFA) and the triglyceride-glucose (TyG) index on the prognosis of overweight and obese coronary artery disease (CAD) patients.
A total of 5,887 patients were enrolled in this study. Restricted cubic spline analyses were used to assess the dose-response relationship of FFA and TyG with major adverse cardiovascular and cerebrovascular events (MACCE). Mediation analysis was used to examine whether TyG mediated the association between FFA and MACCE. Kaplan-Meier survival curves were used to compare the cumulative incidence of events. Multivariable Cox models were used to explore the independent association between Low-/High-FFA and Low-/High-TyG on outcomes.
FFA and TyG were independent predictors of MACCE. TyG mediated 10.7% of the association between FFA and MACCE. Patients with high FFA and TyG levels exhibited a markedly higher MACCE risk (adjusted hazard ratio: 1.951, 95% confidence interval: 1.533-2.484; P < 0.001), with a significant interaction between FFA and TyG. Among patients with elevated FFA levels, MACCE increased progressively across higher TyG tertiles ( P for trend = 0.001).
FFA and the TyG index independently predict adverse outcomes in overweight or obese CAD patients, with the TyG index mediating the relationship between FFA and MACCE. Their combined assessment enhances the risk stratification in this population.

PMID:
42417232
Bibliographic data and abstract were imported from PubMed on 08 Jul 2026.

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