Association between the composite nutritional index TCBI and ISR.

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Metabolic Syndrome Research

Background:

• In-stent restenosis (ISR) is a significant complication following percutaneous coronary intervention (PCI), impacting long-term patient outcomes.
• The underlying mechanisms of ISR are complex and not fully understood.
• The triglyceride-total cholesterol-body weight index (TCBI) is a novel nutritional and metabolic marker, but its role in ISR risk is unclear.

Purpose of the Study:

• To investigate the predictive value of the TCBI for ISR in patients undergoing PCI.
• To compare the predictive performance of TCBI against other metabolic indices.

Main Methods:

• A cohort of 454 patients undergoing PCI were analyzed, categorized by ISR presence based on follow-up coronary angiography.
• Collected data included baseline clinical and laboratory variables; TCBI, atherogenic index of plasma (AIP), atherosclerosis coefficient (AC), residual cholesterol (RC), and triglyceride-glucose (TyG) levels were calculated.
• Statistical analyses included logistic regression, ROC curves, restricted cubic spline modeling, and mediation analysis to assess TCBI's association with ISR and explore underlying mechanisms.

Main Results:

• The TCBI demonstrated the highest predictive performance for ISR (AUC = 0.718), outperforming AIP, AC, RC, and TyG.
• Elevated TCBI was independently associated with increased ISR risk, with a nonlinear relationship observed.
• Mediation analysis suggested that uric acid and white blood cell count partially mediate the association between TCBI and ISR.

Conclusions:

• The TCBI is a valuable metabolic-nutritional marker for ISR risk stratification after PCI.
• TCBI exhibits stronger predictive power for ISR compared to other commonly used indices.
• Further refinement of the TCBI index may enhance its utility in cardiovascular risk assessment.