Abstract
BACKGROUND: The correlation between the triglyceride glucose (TyG) index and atrial fibrillation (AF) risk has been a subject of debate, with existing studies yielding conflicting results. This study aims to explore the effect of the TyG index on the AF risk from a meta-analysis. METHODS: A comprehensive literature search was performed in Web of Science, EMBASE, and PubMed from their inception to December 14, 2024. A meta-analysis was conducted on observational studies that reported on the relationship between the TyG index and AF risk. The subgroup analysis and sensitivity analysis were also performed. RESULTS: In the meta-analysis, seven studies categorized the TyG index and found that those in the highest category had an elevated AF risk ([hazard ratio]HR = 1.96, 95% [confidence interval]CI 1.23-3.11, I(2) = 92%, τ2 = 0.40) when compared to the lowest category. Ten studies treated the TyG index as a continuous measure, revealing that the risk of AF escalated by a factor of 1.94 (HR = 1.94, 95% CI 1.42-2.66, I(2) = 89%, τ2 = 0.25) for every 1-unit/standard deviation (SD) increase in the TyG index. Sensitivity analysis showed that, with each study removed sequentially, the pooled AF risk estimate ranged from 1.66 to 2.19 for categorical TyG index and from 1.75 to 2.09 for continuous TyG index, indicating stable and consistent results. Subgroup analyses indicated that individuals with elevated TyG index values (as a continuous variable) faced a higher risk of AF, and this correlation was uniform across various subgroups, irrespective of post-procedure/ablation status and after accounting for potential confounders such as diabetes mellitus and triglyceride levels. CONCLUSION: An elevated TyG index is independently and consistently associated with a higher risk of AF. These findings support incorporating the TyG index into routine cardiovascular risk assessment to aid in the early identification and prevention of AF.