Associations of C-Reactive Protein-Triglyceride Glucose Index and Estimated Pulse Wave Velocity With All-Cause
Huixiao Yuan1,2, Qingqing Li1,2, Lei Sun3
1Department of General Practice, Shanghai East Hospital Tongji University School of Medicine Shanghai China.
Insights
The C-reactive protein-triglyceride glucose index (CTI) and estimated pulse wave velocity (ePWV) independently and together increase mortality risk in cardiovascular-kidney-metabolic syndrome. These markers may improve risk prediction for CKM syndrome.
Area of Science:
- Cardiovascular Medicine
- Metabolic Syndrome Research
- Biomarker Discovery
Background:
- Cardiovascular-kidney-metabolic (CKM) syndrome involves complex interactions.
- Prognostic value of combined metaflammation and vascular aging markers in CKM syndrome is not well understood.
- This study investigates the C-reactive protein-triglyceride glucose index (CTI) and estimated pulse wave velocity (ePWV).
Purpose of the Study:
- To assess the independent and joint associations of CTI and ePWV with all-cause mortality in CKM syndrome.
- To explore the potential mediation effects between CTI, ePWV, and mortality.
- To evaluate the combined prognostic value of these markers for risk stratification.
Main Methods:
- Prospective cohort study using CHARLS data (2011 and 2015 cohorts).
- Multivariable Cox proportional hazards models and restricted cubic splines were employed.
- Joint effects analyzed by median-based groups; mediation tested using the KHB method.
Main Results:
- Increased CTI (HR=1.56) and ePWV (HR=1.11) were independently associated with higher all-cause mortality risk.
- The group with high CTI and high ePWV exhibited the highest mortality risk (HR=1.73).
- Bidirectional mediation was observed, with ePWV mediating 6.48% of the CTI-mortality link and CTI mediating 2.62% of the ePWV-mortality link.
Conclusions:
- CTI and ePWV are independent and joint predictors of all-cause mortality in CKM syndrome.
- Bidirectional mediation suggests interconnected pathophysiological pathways.
- Integrating CTI and ePWV may enhance risk stratification for CKM syndrome.
Background And Aims:
The combined prognostic value of metaflammation and vascular aging markers in cardiovascular-kidney-metabolic (CKM) syndrome is unclear. This study aimed to assess the independent and joint associations of the C-reactive protein-triglyceride glucose index (CTI) and estimated pulse wave velocity (ePWV) with all-cause mortality.
Methods:
This prospective study included 7183 participants from the CHARLS 2011 survey (original cohort) and 9594 from 2015 (temporal sensitivity analysis cohort). Multivariable Cox models and restricted cubic splines were used. Joint effects were analyzed by median-based groups, and mediation was tested using the KHB method.
Results:
During follow-up, 906 deaths occurred in the original cohort. Each 1-unit increase in CTI was associated with a 56% higher mortality risk (HR = 1.56, 95% CI: 1.37-1.77), and each 1 m/s increase in ePWV with an 11% higher risk (HR = 1.11, 95% CI: 1.05-1.18). The high CTI/high ePWV group had the highest risk (HR = 1.73, 95% CI: 1.31-2.29). ePWV mediated 6.48% of the CTI-mortality association, while CTI mediated 2.62% of the ePWV-mortality association. These findings were confirmed in the temporal sensitivity analysis.
Conclusion:
CTI and ePWV independently and jointly associate with increased all-cause mortality. The observed bidirectional mediation suggests potentially interconnected pathways that warrant further investigation. Integrating these accessible biomarkers could improve risk stratification in CKM syndrome.
Related Concept Videos
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:30Coronary Artery Disease I: Introduction