What is the clinical evidence from this study?

Study design: Cohort. Population: Healthy participants (Cardiovascular risk assessment) (n=9704). Intervention: Triglyceride-total cholesterol-body weight index (TCBI) vs. Traditional atherogenic indices (AIP, AC, CRI-I, CRI-II). Primary outcome: Cardiovascular disease (CVD) mortality (HR 1.078, 95% CI 1.012-1.15, p=0.021).

What does this research mean for the field?

The triglyceride-total cholesterol-body weight index (TCBI) is significantly associated with an increased risk of cardiovascular disease mortality, but it demonstrates weaker predictive capabilities than traditional Castelli risk indices. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 23, 2025Open Access

Beyond traditional metrics: evaluating the triglyceride-total cholesterol-body weight index (TCBI) in cardiovascular risk assessment

MRMohsen RezaeeTabriz University of Medical Sciences FKFarzam KamraniMashhad University of Medical Sciences MIMobina ImannezhadMashhad University of Medical Sciences

Key Result

The triglyceride-total cholesterol-body weight index (TCBI) was significantly associated with an increased risk of cardiovascular disease mortality (HR 1.078) but showed weaker predictive capabilities than traditional Castelli risk indices.

Study Design

Type

Cohort (n=9,704)

Structured PICO

Does the triglyceride-total cholesterol-body weight index (TCBI) predict cardiovascular disease incidence and mortality in a healthy population?

Population

9,704 healthy participants from the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) cohort study, mean age 47.59 (in healthy group), 39% male.

Intervention

Assessment of triglyceride-total cholesterol-body weight index (TCBI) and other atherogenic indices (AIP, AC, CRI-I, CRI-II)

Outcome

CVD incidence and CVD mortality over a 10-year follow-up periodhard clinical

While TCBI is associated with increased CVD mortality, traditional atherogenic indices like CRI-I and CRI-II offer stronger predictive value, suggesting TCBI requires refinement for general population risk assessment.

Main Result

Effect estimate: HR 1.078 (95% CI 1.012-1.15)

p-value: p=0.021

Limitations

Focus on the Iranian population may limit the generalizability of the findings to other demographics.
Identifying some cardiovascular events and mortality through ICD-10 codes may lead to misclassification and reduced accuracy.
TCBI's lipid profile component relies solely on TG and total cholesterol levels, lacking HDL or LDL.

Abstract

BACKGROUND: Cardiovascular disease (CVD), a non-communicable condition, stands as the primary cause of death globally. This study seeks to evaluate the predictive power of atherogenic indices, which are recognized for their influence on CVD, alongside a newly developed index encompassing all three principal risk factors for CVD, referred to as the triglyceride-total cholesterol-body weight index (TCBI). The primary outcomes evaluated include both the incidence and mortality rates associated with CVD. METHODS: A prospective cohort study was conducted on Mashhad stroke and heart atherosclerotic disorder (MASHAD) study data, involving 9704 healthy participants. Baseline variables were measured, and TCBI, Atherogenic Index of Plasma (AIP), Atherogenic Coefficient (AC), Castelli risk index I and II (CRI-I & II) were calculated using specific formulas. RESULTS: Following a 10-year follow-up period, a significant positive relationship was observed between TCBI (HR: 1.078, 95% CI: 1.012-1.15), CRI-I (HR: 1.16, 95% CI: 1.007-1.337), and CRI-II (HR: 1.199, 95% CI: 1.001-1.437) with CVD mortality. However, no significant relationship was identified between TCBI and atherogenic indices related to CVD incidence, and neither AIP nor AC was associated with CVD mortality. CONCLUSION: In conclusion, TCBI, in contrast to AC and AIP, was linked to increased CVD mortality. However, the more substantial predictive capabilities of CRI-I and CRI-II compared to TCBI emphasize the importance of traditional atherogenic indices for accurate risk assessment. These findings underscore the necessity of enhancing the TCBI formula to improve its effectiveness in assessing CVD risk.

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