C-Reactive Protein-Triglyceride Glucose Index and Mortality in Patients with Ventricular Septal Rupture After Acute Myocardial Infarction

Q: What are the key findings of this study?

A high C-reactive protein-triglyceride glucose index was associated with significantly increased 1-year all-cause mortality (87.3% vs 56.3%; OR 2.89) in patients with ventricular septal rupture after acute myocardial infarction.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Ventricular septal rupture after acute myocardial infarction (n=284). Intervention: High C-reactive protein-triglyceride glucose index (CTI ≥ 6.408) vs. Low CTI (< 6.408). Primary outcome: 1-year all-cause mortality (OR 2.89, 95% CI 1.85-4.51, p=<0.001).

Q: What does this research mean for the field?

A high C-reactive protein-triglyceride glucose index is associated with significantly increased 1-year all-cause mortality in patients with ventricular septal rupture following acute myocardial infarction, though this relationship is non-independent and mediated by inflammation and cardiac load. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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

To evaluate the association between the C-reactive protein-triglyceride glucose index and 1-year all-cause mortality in patients with ventricular septal rupture complicating acute myocardial infarction.

Yifeng Chen; Zebin Lin; Xinlong Di; Qinming Hou; Fujian Zhou; Yu Xia; Shengfang Wang; Yiqiang Yuan; Jianmin Tang; Yipin Zhao

doi:10.2147/jir.s606118

August 1, 2026Journal of Inflammation ResearchOpen Access

C-Reactive Protein-Triglyceride Glucose Index and Mortality in Patients with Ventricular Septal Rupture After Acute Myocardial Infarction

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Key result

High C-reactive protein-triglyceride glucose index linked to ~2.9-fold higher 1-year mortality after post-MI ventricular septal rupture.

OR 2.89
95% CI 1.85-4.51
P<0.001
n=284

Figures

Why the study?

Ventricular septal rupture is a life-threatening complication of acute myocardial infarction, and the correlation between the C-reactive protein-triglyceride glucose index and mortality in these patients was unclear.

Does a higher C-reactive protein-triglyceride glucose index (CTI) predict 1-year all-cause mortality in patients with ventricular septal rupture after acute myocardial infarction?

Key Points

To evaluate the association between the C-reactive protein-triglyceride glucose index and 1-year all-cause mortality in patients with ventricular septal rupture complicating acute myocardial infarction.
Consecutive cohort study of 284 patients with post-AMI ventricular septal rupture enrolled between January 2018 and April 2025 at Fuwai Central China Cardiovascular Hospital.
Patients were stratified into low (<6.408, n=142) and high (≥6.408, n=142) groups based on the median C-reactive protein-triglyceride glucose index (CTI).
Multivariate logistic regression and exploratory mediation analyses evaluated the link between CTI and 1-year all-cause mortality.
Overall 1-year all-cause mortality was 71.8% (204/284), occurring in 87.3% (124/142) of the high CTI group versus 56.3% (80/142) of the low CTI group (P < 0.001).
Unadjusted logistic regression showed CTI was linked to higher mortality (OR = 2.89, 95% CI: 1.85–4.51, P < 0.001), but this association lost statistical significance after full adjustment for treatment and laboratory markers in Model 4 (OR = 1.01, 95% CI: 0.54–1.87, P = 0.983).
Mediation analyses identified significant indirect associations through neutrophil count (mediation proportion 65.8%, 95% CI: 17.5–250.2%, P < 0.05) and NT-proBNP (mediation proportion 35.3%, 95% CI: 7.0–144.9%, P < 0.05).

Study Design

Type

Cohort (n=284)

Multicenter

No

Structured PICO

Does a higher C-reactive protein-triglyceride glucose index (CTI) predict 1-year all-cause mortality in patients with ventricular septal rupture after acute myocardial infarction?

P

Population

284 patients aged 18 and older with ventricular septal rupture after acute myocardial infarction, followed for 1 year to evaluate mortality.

E

Exposure

High C-reactive protein-triglyceride glucose index (CTI ≥ 6.408, the median value) or evaluated continuously/by quartiles at admission.

C

Comparator

Low C-reactive protein-triglyceride glucose index (CTI < 6.408) or lower quartiles.

O

Outcome

1-year all-cause mortalityhard clinical

Main Result

Odds Ratio: 2.89 (95% CI 1.85–4.51)

Absolute Event Rate: 87.3% vs 56.3%

p-value: p=<0.001

Limitations

Retrospective design carries risks of selection bias and information bias
Failed to include key clinical variables such as the location and diameter of the ventricular septal rupture and the target vessel lesion
Limited sample of survivors (n=80) may reduce precision and increase the risk of overfitting
Biomarkers were only measured within 24 hours of VSR diagnosis, lacking time series data
Mediation analysis can only suggest potential statistical associations and cannot establish causal relationships
CTI measured at a single time point prevents assessment of longitudinal changes
Retrospective design with selection bias and information bias
Failed to include key clinical variables like location/diameter of VSR and target vessel lesion
Small number of survivors (n=80) limiting multivariable regression and mediation analysis precision
Lack of time series data for CTI and laboratory indicators
Mediation analysis cannot establish causal relationships

Implication

In patients with ventricular septal rupture after acute myocardial infarction, elevated CTI correlates with increased 1-year mortality, although this relationship is not independent and is mediated by systemic inflammation and increased cardiac load.

Abstract

Background: Ventricular septal rupture (VSR) is a life-threatening complication of acute myocardial infarction (AMI). The C-reactive protein-triglyceride glucose index (CTI) integrates insulin resistance (IR) and inflammation. The present study was designed to investigate the correlation between CTI and 1-year all-cause mortality in VSR patients after AMI. Methods: 284 VSR patients were consecutively enrolled at Fuwai Central China Cardiovascular Hospital between January 2018 and April 2025. According to the median CTI value (6.408), the 284 VSR patients were divided into two groups. The relationship between CTI and clinical outcomes was evaluated using multivariate logistic regression analysis, followed by mediation analysis to explore indirect statistical associations. Results: 1-year all-cause mortality in VSR patients was 71.8% (204/284). The mortality of the high CTI group was significantly higher than that of the low CTI group (87.3% vs 56.3%, P < 0.001). Multivariate logistic regression analysis revealed that CTI was associated with mortality (OR = 2.89, 95% CI: 1.85– 4.51, P < 0.001), with mortality showing an upward trend as CTI levels increased ( P < 0.001). Mediation analyses identified indirect statistical associations involving neutrophil count and NT-proBNP, with mediation proportions of 65.8% and 35.3%, respectively (both P < 0.05). Conclusion: CTI is associated with mortality but not independently, with indirect statistical associations involving inflammation and increased cardiac load.

Discussion

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Cite This Study

Chen et al. (2026) conducted a cohort in Ventricular septal rupture after acute myocardial infarction (n=284). High C-reactive protein-triglyceride glucose index (CTI ≥ 6.408) vs. Low CTI (< 6.408) was evaluated on 1-year all-cause mortality (OR 2.89, 95% CI 1.85-4.51, p=<0.001). A high C-reactive protein-triglyceride glucose index was associated with significantly increased 1-year all-cause mortality (87.3% vs 56.3%; OR 2.89) in patients with ventricular septal rupture after acute myocardial infarction.

synapsesocial.com/papers/6ad0fce415427f6a840403b5 https://doi.org/10.2147/jir.s606118

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C-Reactive Protein-Triglyceride Glucose Index and Mortality in Patients with Ventricular Septal Rupture After Acute Myocardial Infarction

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

C-Reactive Protein-Triglyceride Glucose Index and Mortality in Patients with Ventricular Septal Rupture After Acute Myocardial Infarction

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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