Association of the c-reactive protein-triglyceride glucose index with myocardial ischemia in patients with minimal to moderate coronary artery disease

Objective This study sought to explore the relationship between the C-reactive protein-triglyceride-glucose index (CTI) and the incidence of myocardial ischemia in patients with minimal to moderate coronary artery disease (CAD). Methods The research retrospectively included 707 patients who underwent coronary computed tomography angiography (CTA) and blood tests for triglycerides, glucose, and C-reactive protein (CRP). CTI was calculated as: CTI = 0.412 × Ln(CRP [mg/L]) + Ln(TG [mg/dl] × FPG [mg/dl])/2. The definition of myocardial ischemia included coronary computed tomography angiography-derived fractional flow reserve (CT-FFR) measurements at or below 0.80. Multivariable logistic regression and subgroup analysis were performed to assess the association between CTI and myocardial ischemia. Results The mean age of these 707 patients with minimal to moderate CAD was 63.9 ± 10.2 years, with 52.9% being male. After adjusting for other basic characteristics and/or coronary CTA features, the highest CTI quartile (T4) was linked with an increased risk of myocardial ischemia across four models, with odds ratios (ORs) ranging from 2.11 to 2.59 (all p < 0.05). Moreover, increasing the CTI by 1-SD was associated with a 24–30% increased risk of myocardial ischemia in all four models (all p < 0.05). Subgroup analysis showed that segment involvement score (SIS) ≥ 2 and moderate stenosis (50%–69%) were positively correlated with myocardial ischemia and the CTI. Conclusion The study demonstrates that CTI is independently associated with myocardial ischemia detected by CT-FFR in individuals with minimal to moderate CAD. Notably, the predictive strength of CTI is particularly significant in patients with higher plaque burdens (SIS ≥ 2) and moderate stenosis (50%–69%), suggesting its potential to further identify truly high-risk individuals within the minimal to moderate CAD population.