Frontiers in cardiovascular medicine · 2026
The association between C-reactive protein-triglyceride glucose index and all-cause mortality in patients with cardiovascular-kidney-metabolic syndrome: a single-center retrospective cohort study.
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Lin Jiacai, Qiu Shaobin, Su Shuling, Ni Weixin, Lin Yongluan, Ni Xiaobin
Аннотация
BACKGROUND: Patients with cardiovascular-kidney-metabolic (CKM) syndrome have high mortality risk. The C-reactive protein-triglyceride glucose index (CTI) integrates inflammation and insulin resistance, yet its stage-specific prognostic value is undefined.
METHODS AND RESULTS: This retrospective cohort study included 8,632 CKM patients (2020-2025), stratified by CTI quartiles. All-cause mortality was assessed using adjusted Cox models. Among 860 deaths (10.0%), CTI was an independent mortality predictor in both stage 0-3 (HR 1.68, 95% CI 1.30-2.18) and stage 4 CKM (HR 1.54, 1.33-1.77). Compared with Q1, Q4 patients had significantly higher risk (stage 0-3: HR 4.57, 2.32-8.99; stage 4: HR 2.26, 1.64-3.13). A linear dose-response relationship was confirmed (P for nonlinear >0.05). CTI showed superior 1-year predictive performance over TyG index (AUC: stage 0-3, 0.73 vs. 0.62; stage 4, 0.69 vs. 0.51).
CONCLUSION: CTI is a potent, independent predictor of all-cause mortality in CKM, with a linear dose-response relationship. By integrating inflammatory and metabolic pathways, it provides superior risk stratification over TyG index, highlighting its clinical utility.
METHODS AND RESULTS: This retrospective cohort study included 8,632 CKM patients (2020-2025), stratified by CTI quartiles. All-cause mortality was assessed using adjusted Cox models. Among 860 deaths (10.0%), CTI was an independent mortality predictor in both stage 0-3 (HR 1.68, 95% CI 1.30-2.18) and stage 4 CKM (HR 1.54, 1.33-1.77). Compared with Q1, Q4 patients had significantly higher risk (stage 0-3: HR 4.57, 2.32-8.99; stage 4: HR 2.26, 1.64-3.13). A linear dose-response relationship was confirmed (P for nonlinear >0.05). CTI showed superior 1-year predictive performance over TyG index (AUC: stage 0-3, 0.73 vs. 0.62; stage 4, 0.69 vs. 0.51).
CONCLUSION: CTI is a potent, independent predictor of all-cause mortality in CKM, with a linear dose-response relationship. By integrating inflammatory and metabolic pathways, it provides superior risk stratification over TyG index, highlighting its clinical utility.