A novel predictor behind conventional risk factors of new-onset atrial fibrillation after off-pump coronary artery bypass graft surgery: The triglyceride-glucose index

Aim: Atrial fibrillation (AF), which frequently occurs after coronary artery bypass graft surgery (CABG), raises the risk of adverse events such as stroke and heart failure. Insulin resistance (IR) is a major risk factor for developing postoperative AF (POAF), and the triglyceride-glucose (TyG) index offers a more precise and reliable assessment of IR compared to the homeostasis model. This study investigated the correlation between preoperative TyG index levels and POAF in patients undergoing off -pump CABG. Material and Methods: Four hundred sixteen patients undergoing isolated off -pump CABG were included in the study. The preoperative TyG index and the presence of POAF were evaluated in all patients. Significant variables (P<0.05) from univariate analysis were included in multivariate logistic regression to identify potential POAF risk factors. The TyG index's predictive efficacy for POAF was assessed in two models: one with conventional risk factors and the other adding the TyG index. Results: POAF was detected in 106 patients (25.5%), with significantly higher TyG index levels observed in POAF patients compared to those without POAF [9.8 (8.0-11.7) vs. 9.0 (7.7-11.1), P<0.001]. The TyG index was found to be an independent predictor of POAF (P<0.001) with moderate predictive power (AUC=0.767). Adding the TyG index to the model, which included age and left atrial diameter, significantly improved its predictive capacity for POAF (P=0.038). Discussion: In our retrospective study, we identified the TyG index as an independent predictor of POAF in patients undergoing off -pump CABG.