BMC neurology · 2026
Association of high-sensitivity C-reactive protein-triglyceride glucose index and stroke outcomes: results from the China National Stroke Registry III.
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Dai Liye, Sun Yiting, Yin Jinfeng, Jiang Yong, Li Hao, Wang Yongjun, Meng Xia
Аннотация
BACKGROUND: The high-sensitivity C-reactive protein-triglyceride glucose index (hsCTI) is an integrated biomarker reflecting systemic inflammation and insulin resistance. This study aimed to evaluate the association between hsCTI levels and the risk of stroke recurrence in a large, real-world cohort.
METHODS: We analyzed data from the China National Stroke Registry-III, including patients with acute ischemic stroke or transient ischemic attack (TIA). The hsCTI was calculated as 0.412 × ln(hsCRP [mg/L]) + ln(TG [mg/dL] × FPG [mg/dL]/2). Outcomes included stroke recurrence, ischemic stroke recurrence, and composite vascular events. Kaplan-Meier curves and Cox proportional hazards models were employed to evaluate the association between hsCTI and clinical outcomes, stratified by sex, age, and glycemic status. The area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated to evaluate the incremental risk prediction capabilities of hsCTI and TyG index beyond traditional risk factors.
RESULTS: Among 4,969 included patients (67.8% male), those in the highest hsCTI quartile (Q4) experienced increased risks of recurrent stroke and composite vascular events during a maximum follow-up of 5 years. Compared with the lowest quartile, Q4 was associated with significantly elevated 3-month stroke recurrence (adjusted hazard ratio [aHR], 1.83; 95% CI, 1.23-2.73) and composite vascular events (aHR, 2.04; 95% CI, 1.38-3.00), with associations remaining significant at 1 year. The prognostic value was most pronounced in individuals aged ≥ 60 years. Subgroup analyses identified significant interactions between hsCTI and age (P for interaction = 0.009), as well as National Institutes of Health Stroke Scale (NIHSS) score at admission (P for interaction = 0.017). Adding hsCTI to the reference model significantly improved clinical risk prediction (all P < 0.001for NRI and IDI).
CONCLUSIONS: Elevated baseline hsCTI level was associated with an increased risk of stroke recurrence and composite vascular events. HsCTI may serve as a potential biomarker for identifying residual vascular risks.
METHODS: We analyzed data from the China National Stroke Registry-III, including patients with acute ischemic stroke or transient ischemic attack (TIA). The hsCTI was calculated as 0.412 × ln(hsCRP [mg/L]) + ln(TG [mg/dL] × FPG [mg/dL]/2). Outcomes included stroke recurrence, ischemic stroke recurrence, and composite vascular events. Kaplan-Meier curves and Cox proportional hazards models were employed to evaluate the association between hsCTI and clinical outcomes, stratified by sex, age, and glycemic status. The area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated to evaluate the incremental risk prediction capabilities of hsCTI and TyG index beyond traditional risk factors.
RESULTS: Among 4,969 included patients (67.8% male), those in the highest hsCTI quartile (Q4) experienced increased risks of recurrent stroke and composite vascular events during a maximum follow-up of 5 years. Compared with the lowest quartile, Q4 was associated with significantly elevated 3-month stroke recurrence (adjusted hazard ratio [aHR], 1.83; 95% CI, 1.23-2.73) and composite vascular events (aHR, 2.04; 95% CI, 1.38-3.00), with associations remaining significant at 1 year. The prognostic value was most pronounced in individuals aged ≥ 60 years. Subgroup analyses identified significant interactions between hsCTI and age (P for interaction = 0.009), as well as National Institutes of Health Stroke Scale (NIHSS) score at admission (P for interaction = 0.017). Adding hsCTI to the reference model significantly improved clinical risk prediction (all P < 0.001for NRI and IDI).
CONCLUSIONS: Elevated baseline hsCTI level was associated with an increased risk of stroke recurrence and composite vascular events. HsCTI may serve as a potential biomarker for identifying residual vascular risks.