C-reactive protein-triglyceride glucose index in predicting three-vessel coronary artery disease risk: a
Ling Hou1,2,3, Yuanhong Li1, Qianfei Liu4,5
1Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Enshi, Hubei Province, People's Republic of China.
Insights
The C-reactive protein-triglyceride glucose index (CTI) effectively predicts three-vessel coronary artery disease (TVD). Elevated CTI is a significant risk factor, valuable for improving patient assessment and stratification in clinical practice.
Area of Science:
- Cardiovascular Medicine
- Biomarker Discovery
- Metabolic Syndrome Research
Background:
- Three-vessel coronary artery disease (TVD) is a severe form of coronary heart disease linked to inflammation and metabolic issues.
- The C-reactive protein-triglyceride glucose index (CTI) combines inflammation and metabolism markers, suggesting potential as a TVD predictor.
Purpose of the Study:
- To evaluate the predictive capability of the CTI for identifying three-vessel coronary artery disease (TVD).
- To assess the role of CTI in risk stratification for TVD patients.
Main Methods:
- A retrospective study comparing TVD and non-TVD groups on clinical and laboratory markers.
- Utilized Boruta algorithm and LASSO regression for feature selection and risk model construction.
- Employed SHAP analysis for model interpretability and subgroup analyses by sex and diabetes status.
Main Results:
- The CTI index was significantly elevated in the TVD group and identified as a key predictor alongside age and gender.
- SHAP analysis confirmed CTI's prominent role in TVD risk assessment.
- CTI showed a stable predictive effect across subgroups of men and diabetic patients.
Conclusions:
- The CTI is a reliable predictor for TVD, offering immediate value for risk assessment and patient stratification.
- CTI shows promise for future applications in early screening and long-term management of TVD.
Background:
Three-vessel coronary artery disease (TVD) is a severe subtype of coronary heart disease, strongly associated with inflammation and metabolic dysfunction. The C-reactive protein-triglyceride glucose index (CTI), an integrated measure of inflammation and metabolism, may serve as a critical predictor of TVD risk. This study evaluates the predictive utility of CTI for TVD.
Methods:
This single-center retrospective study compared clinical characteristics, laboratory indices, and inflammation- and metabolism-related markers between TVD and non-TVD groups. Feature selection using the Boruta algorithm and LASSO regression identified key predictors for constructing a TVD risk model. SHAP analysis provided model interpretability and evaluated the relative importance of predictive factors. Predefined subgroup analyses by sex and diabetes status were conducted using multivariable logistic regression, with interaction terms tested to assess the consistency of CTI's predictive effect across subgroups.
Results:
Traditional risk factors, including gender, age, hypertension, diabetes, and smoking, were significantly more prevalent in the TVD group. The CTI index was markedly elevated in this group and emerged as a critical predictor. Boruta and LASSO identified CTI, age, and gender as primary predictors. SHAP analysis confirmed the prominent role of CTI, with age and gender also contributing significantly to risk prediction. CTI demonstrated the strongest positive impact on TVD risk assessment. Subgroup analyses showed CTI was significantly associated with TVD in men and diabetic patients, with no significant interaction by sex or diabetes, indicating a generally stable predictive effect.
Conclusion:
CTI is a reliable predictor of TVD with immediate value for improving current risk assessment and patient stratification. Beyond its present clinical relevance, CTI also holds potential for future applications in early screening and long-term management.
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