Utility of Tei Index, carotid IMT, and crouse score in coronary artery calcification assessment and MACCE prediction in elderly patients

Q: What are the key findings of this study?

The synergistic application of Tei index, carotid IMT, and Crouse score enhanced diagnostic accuracy for severe coronary artery calcification (AUC 0.831) and predicted MACCE recurrence in elderly CHD patients.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Coronary heart disease with severe coronary artery calcification (n=98). Intervention: Combined Tei index, carotid IMT, and Crouse plaque score vs. Individual biomarkers. Primary outcome: Severe coronary artery calcification diagnosis (Combined ROC) (AUC 0.831, 95% CI 0.740-0.923, p=<0.001).

Q: What does this research mean for the field?

The combined application of the Tei index, carotid intima-media thickness (IMT), and Crouse score significantly improves the diagnostic accuracy of severe coronary artery calcification and effectively predicts the risk of major adverse cardiovascular and cerebrovascular events (MACCE) recurrence in elderly patients with coronary heart disease. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To assess the diagnostic accuracy and prognostic value of combining the myocardial performance index (Tei index), carotid intima-media thickness (IMT), and Crouse plaque score in elderly coronary heart disease patients.

Haifeng Zang; Peiliang Cheng; Caifei Jin

doi:10.3389/fcvm.2026.1781737

May 21, 2026Frontiers in Cardiovascular MedicineOpen Access

Utility of Tei Index, carotid IMT, and crouse score in coronary artery calcification assessment and MACCE prediction in elderly patients

View Full Paper

Ask AI

Bookmark

Share

Key result

Combined Tei index, carotid IMT, and Crouse score predicts severe CAC with ~83% accuracy and MACCE.

AUC 0.831
95% CI 0.740-0.923
P<0.001
n=98

Figures

Why the study?

The study evaluated the diagnostic and prognostic value of integrating Tei index, carotid IMT, and Crouse plaque score for assessing CAC severity and MACCE recurrence in elderly CHD patients.

Does the integration of Tei index, carotid IMT, and Crouse plaque score predict severe coronary artery calcification and MACCE recurrence in elderly CHD patients?

Key Points

To assess the diagnostic accuracy and prognostic value of combining the myocardial performance index (Tei index), carotid intima-media thickness (IMT), and Crouse plaque score in elderly coronary heart disease patients.
Retrospective analysis of 98 elderly CHD patients (aged ≥60 years; 2019–2022) at South Taihu Hospital stratified into severe calcification (CACS ≥ 100, n = 45) and control (CACS < 100, n = 53) groups.
Patients underwent echocardiography to assess Tei index, carotid Doppler ultrasound for IMT and Crouse score, and coronary computed tomography angiography to calculate Agatston calcification scores.
Multivariate logistic regression, Spearman correlation, ROC curve analyses, and Kaplan–Meier survival curves were used to assess calcification risk and predict MACCE recurrence.
Patients with severe calcification exhibited significantly higher Tei index [0.58 (0.51, 0.72) vs. 0.44 (0.35, 0.52)], IMT [1.11 (0.89, 1.26) mm vs. 0.72 (0.62, 0.80) mm], and Crouse score [1.83 (1.04, 2.56) vs. 0.90 (0.77, 1.09)] (all p < 0.001).
Tei index, IMT, and Crouse score were independent predictors of severe calcification (OR = 2.634–73.061, p < 0.05), and their combination yielded higher diagnostic accuracy (AUC = 0.831, 95% CI: 0.740–0.923) than individual biomarkers (AUC = 0.778–0.792).
Threshold values of Tei index ≥ 0.50, IMT ≥ 0.86 mm, and Crouse score ≥ 1.21 each predicted significantly elevated risks of MACCE recurrence (log-rank p < 0.001).

Study Design

Type

Cohort (n=98)

Multicenter

No

Structured PICO

Does the integration of Tei index, carotid IMT, and Crouse plaque score predict severe coronary artery calcification and MACCE recurrence in elderly CHD patients?

P

Population

98 elderly patients (aged ≥60 years) with coronary heart disease (CHD) who underwent percutaneous coronary intervention (PCI), from a single center in China. Stratified into severe calcification (CACS ≥ 100, n=45) and control (CACS < 100, n=53) groups. Excluded malignancies, severe organ dysfunction, prior revascularization, and heart failure.

I

Intervention

Assessment of myocardial performance index (Tei index), carotid intima-media thickness (IMT), and Crouse plaque score via echocardiography and carotid ultrasound.

C

Comparator

Comparison between severe calcification (CACS ≥ 100) and control (CACS < 100) groups, and between high vs. low values of the ultrasound parameters.

O

Outcome

Severe coronary artery calcification (single-vessel CACS ≥ 100) and major adverse cardiovascular and cerebrovascular events (MACCE: all-cause death, non-fatal myocardial infarction, target vessel revascularization, and non-fatal stroke).composite

Main Result

Effect estimate: AUC 0.831 (95% CI 0.740-0.923)

p-value: p=<0.001

The synergistic use of Tei index, carotid IMT, and Crouse score provides a noninvasive method to enhance the diagnosis of severe coronary artery calcification and stratify MACCE risk in elderly CHD patients.

Limitations

Single-center study with a relatively small cohort, which may not be fully representative and risks model overfitting.
All included cases were coronary heart disease patients, limiting applicability to the general population.
Study group was defined by a focal calcification threshold (single-vessel CACS ≥ 100) rather than the total Agatston score.
High-risk thresholds were derived from the diagnostic ROC analysis in the same cohort and require external validation.

Implication

May aid noninvasive CAC assessment in elderly CHD; hypothesis-generating for MACCE risk pending prospective validation.

Abstract

Objective Current study aims to evaluate the diagnostic and prognostic value of integrating myocardial performance index (Tei index), carotid intima-media thickness (IMT), and Crouse plaque score in coronary artery calcification (CAC) severity and major adverse cardiovascular and cerebrovascular events (MACCE) recurrence among elderly coronary heart disease (CHD) patients Methods A retrospective study included 98 elderly CHD patients (2019–2022) from South Taihu Hospital. Coronary artery calcification score (CACS) was assessed, with severe calcification defined as single-vessel CACS ≥ 100. Participants were stratified into severe calcification ( n = 45) and control (CACS < 100, n = 53) groups. Baseline characteristics, Tei index, IMT, and Crouse score were compared. Multivariate logistic regression identified CAC risk factors. Spearman analysis assessed correlations between CACS and biomarkers. Receiver operating characteristic (ROC) curves evaluated combined diagnostic performance. Kaplan–Meier survival analysis predicted MACCE recurrence using optimal thresholds from ROC. Results The severe calcification group exhibited elevated Tei index [0.58 (0.51, 0.72) vs. 0.44 (0.35, 0.52)], IMT [1.11 (0.89, 1.26) mm vs. 0.72 (0.62, 0.80) mm], and Crouse score [1.83 (1.04, 2.56) vs. 0.90 (0.77, 1.09)] compared to controls (all p < 0.001). These parameters independently predicted severe CAC (OR = 2.634–73.061, p < 0.05) and correlated positively with number of stenosed coronary vessel ( r = 0.429–0.453, p < 0.01). Combined ROC analysis demonstrated superior diagnostic accuracy (AUC = 0.831, 95% CI:0.740–0.923) vs. individual biomarkers (AUC = 0.778–0.792). High Tei index (≥0.50), IMT (≥0.86 mm), and Crouse score (≥1.21) predicted increased MACCE risk (log-rank p < 0.001). Conclusion The synergistic application of Tei index, carotid IMT, and Crouse score enhances CAC diagnosis precision and stratifies MACCE recurrence risk in elderly CHD patients, offering a noninvasive strategy for postoperative risk management.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Zang et al. (2026) conducted a cohort in Coronary heart disease with severe coronary artery calcification (n=98). Combined Tei index, carotid IMT, and Crouse plaque score vs. Individual biomarkers was evaluated on Severe coronary artery calcification diagnosis (Combined ROC) (AUC 0.831, 95% CI 0.740-0.923, p=<0.001). The synergistic application of Tei index, carotid IMT, and Crouse score enhanced diagnostic accuracy for severe coronary artery calcification (AUC 0.831) and predicted MACCE recurrence in elderly CHD patients.

synapsesocial.com/papers/6a13e67d0e02ee3982d316a0 https://doi.org/10.3389/fcvm.2026.1781737

View Full Paper

Ask AI

Bookmark

Share

Utility of Tei Index, carotid IMT, and crouse score in coronary artery calcification assessment and MACCE prediction in elderly patients

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Utility of Tei Index, carotid IMT, and crouse score in coronary artery calcification assessment and MACCE prediction in elderly patients

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading