Prognostic value of a novel indicator integrating C-reactive protein-triglyceride glucose index and coronary physiological burden in patients undergoing PCI: a prospective cohort study

Figures

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  Figure 1. Study flowchart. PCI, percutaneous coronary intervention; μQFR, Murray’s law-based quantitative flow ratio; CABG, coronary artery bypass grafting; CTI, C-reactive protein-triglyceride glucose index; 3 V-μQFR, three-vessel μQFR; μCTI, combined 3 V-μQFR and CTI index; Q, quartile.

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  Figure 2. ROC curves and time-dependent AUC analysis for MACCE prediction by different models. (A) ROC curves for predicting MACCE. (B) Time-dependent AUC analysis over the follow-up period. The table summarizes the AUC, difference in AUC, NRI, and IDI for each model compared to the μCTI model. MACCE, major adverse cardiovascular and cerebrovascular events; AUC, area under the curve; μCTI, combined 3 V-μQFR and CTI index; TyG, triglyceride-glucose index; hs-CRP, high-sensitivity C-reactive protein; 3 V-μQFR, three-vessel μQFR; CTI, C-reactive protein-triglyceride glucose index; NRI, net reclassification improvement; IDI, integrated discrimination improvement.

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  Figure 3. Kaplan–Meier curves for cumulative incidence of MACCE and its components according to μCTI quartiles. Kaplan–Meier curves are shown for (a) All-cause death, (b) MI, (c) IDR, (d) Stroke, and the composite endpoint of MACCE across quartiles (Q1–Q4) of the μCTI index. MACCE, Major adverse cardiovascular and cerebrovascular events; μCTI, Combined 3 V-μQFR and CTI index; Q, Quartile; MI, Myocardial infarction; IDR, Ischemia-driven revascularization.

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  Figure 4. RCS analysis of the association between μCTI, CTI, 3 V-μQFR and MACCE risk. RCS curves show the dose–response relationships of μCTI, CTI, and 3 V-μQFR with MACCE risk. Model 0 (A, E, I): Unadjusted model. Model 1 (B, F, J): Adjusted for age and gender. Model 2 (C, G, K): Adjusted for Model 1 + hypertension, diabetes, smoking, previous MI, previous PCI and clinical diagnosis. Model 3 (D, H, L): Adjusted for Model 2 + LVEF, BMI, Scr, HbA1c, LDL-C, HDL-C and TC. RCS, restricted cubic spline; μCTI, combined 3 V-μQFR and CTI index; CTI, C-reactive protein-triglyceride glucose index; 3 V-μQFR, three-vessel μQFR; MACCE, major adverse cardiovascular and cerebrovascular events; MI, myocardial infarction; PCI, percutaneous coronary intervention; LVEF, left ventricular ejection fraction; BMI, body mass index; Scr, serum creatinine; HbA1c, glycated hemoglobin; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; TC, total cholesterol.

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  Figure 5. Subgroup analysis of the association between μCTI (per SD increase) and MACCE risk. Forest plot showing the HR and 95% CI for the association between each SD increase in μCTI and MACCE risk across predefined clinical subgroups. P for interaction > 0.05 for all subgroups, indicating no significant heterogeneity. HR, Hazard ratio; CI, Confidence interval; BMI, Body mass index; MI, Myocardial infarction; PCI, Percutaneous coronary intervention; STEMI, ST-segment elevation myocardial infarction; NSTEMI, Non-ST-segment elevation myocardial infarction; UA, Unstable angina; CCS, Chronic coronary syndromes; μCTI, Combined 3 V-μQFR and CTI index; 3 V-μQFR, Three-vessel μQFR; CTI, C-reactive protein-triglyceride glucose index; SD, Standard deviation; MACCE, Major adverse cardiovascular and cerebrovascular events.