What is the clinical evidence from this study?

Study design: Observational. Population: Acute myocardial infarction (n=967). Intervention: C-reactive protein-triglyceride glucose index (CTI) vs. Lower CTI levels. Primary outcome: Occurrence of microvascular obstruction (MVO) assessed by CMR (OR 1.33, 95% CI 1.13-1.56, p=0.001).

July 15, 2026Frontiers in Endocrinology0 citationsOpen Access

Association of the C-reactive protein-triglyceride glucose index with microvascular obstruction and long-term prognosis in patients with acute myocardial infarction: a CMR-based study

LCLei ChenTongji University DZDexiang ZongDuke-NUS Medical School PLPeng LuXuzhou Medical College

Key Result

Higher baseline C-reactive protein-triglyceride glucose index levels were independently associated with an increased risk of microvascular obstruction (OR 1.33) in patients with acute myocardial infarction.

Study Design

Type

Observational (n=967)

Multicenter

Structured PICO

Does a higher C-reactive protein-triglyceride glucose index (CTI) predict microvascular obstruction and long-term MACE in patients with acute myocardial infarction undergoing primary PCI?

Population

967 patients (mean age 58 years, 17.8% female) with acute myocardial infarction who underwent successful primary PCI and cardiac magnetic resonance imaging, followed for a median of 43 months.

Exposure

Higher baseline C-reactive protein-triglyceride glucose index (CTI) levels

Comparator

Lower baseline CTI levels

Outcome

Occurrence of microvascular obstruction (MVO) assessed by CMRsurrogate

The C-reactive protein-triglyceride glucose index is a useful biomarker for predicting microvascular obstruction and long-term adverse events in patients with acute myocardial infarction after primary PCI, particularly in those without diabetes.

Main Result

Odds Ratio: 1.33 (95% CI 1.13–1.56)

p-value: p=0.001

Limitations

Single-center retrospective design with potential unmeasured residual confounders
Exclusion of patients unable to tolerate CMR may limit generalizability
CTI was calculated based on laboratory measurements at a single time point
Lack of external validation

Abstract

Background: The clinical benefits of percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) are frequently compromised by the occurrence of microvascular obstruction (MVO). The C-reactive protein-triglyceride glucose index (CTI) is a novel biomarker integrating systemic inflammation and insulin resistance. We aimed to evaluate the association between CTI and MVO, as well as its prognostic value for long-term outcomes in AMI patients. Methods: This study included patients with AMI who underwent successful primary PCI and subsequent cardiac magnetic resonance (CMR). MVO and cardiac function were assessed by CMR. The primary endpoint was the occurrence of MVO, and the secondary endpoint was the incidence of major adverse cardiovascular events (MACE). Results: A total of 967 patients were ultimately included, comprising 255 with diabetes mellitus and 712 without diabetes; 476 patients developed CMR-defined MVO. Higher baseline CTI levels were significantly and independently associated with an increased risk of MVO (OR = 1.33, 95% CI: 1.13-1.56, P = 0.001). A linear dose-response relationship was observed between CTI and MVO risk (P for overall 0.05). During a median follow-up of 43 months, higher CTI levels were associated with an increased risk of long-term MACE in the overall population and the non-diabetic subgroup, whereas this association was attenuated in patients with diabetes mellitus. Conclusions: CTI is independently associated with MVO after PCI in AMI patients and shows modest prognostic value for long-term MACE, particularly in patients without diabetes. As a clinically accessible tool, CTI may facilitate early risk stratification and individualized microvascular protection strategies following PCI.

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