{
  "abstract": "Background\n\nInsulin resistance (IR) is closely associated with the development and recurrence of atrial fibrillation (AF). Several non-insulin-based surrogate markers of insulin resistance, including the triglyceride-glucose index (TyG), triglyceride-glucose-body mass index (TyG-BMI), metabolic score for insulin resistance (METS-IR), triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C), estimated glucose disposal rate (eGDR), and C-reactive protein-triglyceride-glucose index (CTI), can be calculated from routine clinical biomarkers. However, the value of these indices in predicting recurrence after catheter ablation for AF remains unclear. In particular, CTI, a novel marker integrating inflammatory and metabolic status, has not been fully explored for its potential role in predicting post-ablation AF recurrence. This study aimed to systematically evaluate the association and predictive performance of six insulin resistance surrogate markers for AF recurrence after catheter ablation.Methods\n\nThis retrospective two-center cohort study included 590 patients with nonvalvular AF who underwent first-time catheter ablation between January 2022 and March 2025. Six IR surrogate indices were calculated, and AF recurrence within 1 year was defined as the primary endpoint. Multivariable Cox regression, Kaplan-Meier analysis, restricted cubic spline (RCS) analysis, C-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to assess associations and predictive value.Results\n\nDuring 1-year follow-up, 167 patients experienced recurrence (28.31%). Multivariable Cox analysis showed that lower eGDR and higher TyG, TyG-BMI, METS-IR, and CTI were associated with increased recurrence risk, with more stable associations observed for eGDR, TyG-BMI, METS-IR, and CTI. Kaplan-Meier and RCS analyses further supported stratified differences and exposure-response relationships for some indices. For predictive performance, eGDR showed the most favorable overall performance, while CTI, TyG-BMI, and METS-IR also provided incremental predictive value. TyG and TG/HDL-C showed relatively limited incremental value. After false discovery rate correction, subgroup analyses showed generally consistent results.Conclusion\n\nAmong the six IR surrogate indices, eGDR, CTI, TyG-BMI, and METS-IR were associated with AF recurrence after catheter ablation. eGDR showed the most favorable overall predictive performance. These indices may serve as adjunctive markers for post-ablation recurrence risk stratification, although prospective validation is needed.",
  "abstract_shown": true,
  "affiliations": [
    "The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou, 730030, China.",
    "The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou, 730030, China. pchang@lzu.edu.cn.",
    "Department of cardiology, Lanzhou University Second Hospital, Lanzhou, 730030, China. pchang@lzu.edu.cn."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zhaofen Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Haijuan Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaoxue Guo"
    },
    {
      "affs": [
        0
      ],
      "name": "Chu Zhang"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Peng Chang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6zbhd371fh2s1.bib",
  "cited_by": 0,
  "doi": "10.1186/s12933-026-03306-w",
  "fulltext_url": "https://europepmc.org/articles/PMC13685086",
  "id": "6zbhd371fh2s1",
  "issns": [
    "1475-2840"
  ],
  "landing_url": "https://europepmc.org/article/MED/42902277",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC666-701"
    ],
    [
      "openalex",
      "2705|Atrial Fibrillation Management and Outcomes"
    ]
  ],
  "openalex": "W7171245310",
  "pdf_url": "https://europepmc.org/articles/PMC13685086?pdf=render",
  "pmcid": "PMC13685086",
  "pmid": "42902277",
  "published": "2026-07-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/6zbhd371fh2s1.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:41Z",
      "native_id": "MED:42902277",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42902277"
    },
    {
      "first_seen": "2026-10-30T13:45:33Z",
      "native_id": "5460f8712b614d328a856d8432174e7a",
      "source": "doaj",
      "url": "https://doi.org/10.1186/s12933-026-03306-w"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Atrial Fibrillation Management and Outcomes",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Association between insulin resistance-related indices and the risk of recurrence after catheter ablation in patients with nonvalvular atrial fibrillation.",
  "title_text": "Association between insulin resistance-related indices and the risk of recurrence after catheter ablation in patients with nonvalvular atrial fibrillation.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:45:33Z",
  "url": "https://research.draconitic.com/paper/6zbhd371fh2s1",
  "venue": "Cardiovascular diabetology",
  "versions": []
}