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Peer-reviewedCC BY 4.0Frontiers in Cardiovascular Medicine

Novel cholesterol-high-density lipoprotein-glucose index is associated with 1-year recurrence of atrial fibrillation after catheter ablation

  • Kamila Kamili1
  • Suining Xu1
  • Xiyang Li1
  • Danni Wang1
  • Pengjie Gao1
  • Gang Tian1
  • Haijian Xing2
  1. 1Department of Cardiovascular Medicine, First Affiliated Hospital of Xi’an Jiaotong University
  2. 2Department of Outpatient Internal Medicine, Affiliated Children’s Hospital of Xi'an Jiaotong University
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Abstract

Objective: Insulin resistance (IR) plays a pivotal role in the pathogenesis of atrial fibrillation (AF). The novel cholesterol-high-density lipoprotein-glucose (CHG) index, which integrates total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and fasting blood glucose (FBG), has not been validated for predicting AF recurrence following radiofrequency catheter ablation (RFCA). This study aimed to evaluate the association between the CHG index and 1-year AF recurrence after RFCA, and to compare its performance with the triglyceride-glucose (TyG) index.

Methods: A retrospective cohort of 813 AF patients who underwent first-time RFCA was enrolled. The primary outcome was any atrial tachyarrhythmia lasting ≥ 30 s after a 3-month blanking period. Cox regression, ROC curve, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to assess predictive performance.

Results: During 1-year follow-up, 142 patients (17.5%) had recurrent atrial tachyarrhythmia, with significantly higher CHG levels in the recurrence group ( P < 0.001). Each unit increase in the CHG index was associated with a 4.23-fold higher risk of recurrence (HR = 4.231, 95% CI: 3.406–5.257, P < 0.001). The restricted cubic spline curve shows a dose-response relationship between CHG and AF recurrence. The CHG index yielded an AUC of 0.765, superior to TyG (AUC = 0.673). Adding the CHG index to the traditional risk model significantly improved NRI (0.434, P < 0.001) and IDI (0.200, P < 0.001), with greater improvement than adding the TyG index. Subgroup analyses demonstrated consistent predictive effects across different populations.

Conclusions: The CHG index is an independent risk marker for 1-year recurrence after AF ablation and demonstrates superior discriminative ability compared to the TyG index.

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Cite

BibTeXRIS
BibTeX
@article{kamili2026novel,
  title = {{Novel cholesterol-high-density lipoprotein-glucose index is associated with 1-year recurrence of atrial fibrillation after catheter ablation}},
  author = {Kamila Kamili and Suining Xu and Xiyang Li and Danni Wang and Pengjie Gao and Gang Tian and Haijian Xing},
  journal = {Frontiers in Cardiovascular Medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fcvm.2026.1982137},
  url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1982137/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Novel cholesterol-high-density lipoprotein-glucose index is associated with 1-year recurrence of atrial fibrillation after catheter ablation
AU  - Kamila Kamili
AU  - Suining Xu
AU  - Xiyang Li
AU  - Danni Wang
AU  - Pengjie Gao
AU  - Gang Tian
AU  - Haijian Xing
PY  - 2026
DA  - 2026/10/29
JO  - Frontiers in Cardiovascular Medicine
DO  - 10.3389/fcvm.2026.1982137
UR  - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1982137/full
AB  - Objective: Insulin resistance (IR) plays a pivotal role in the pathogenesis of atrial fibrillation (AF). The novel cholesterol-high-density lipoprotein-glucose (CHG) index, which integrates total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and fasting blood glucose (FBG), has not been validated for predicting AF recurrence following radiofrequency catheter ablation (RFCA). This study aimed to evaluate the association between the CHG index and 1-year AF recurrence after RFCA, and to compare its performance with the triglyceride-glucose (TyG) index.  Methods: A retrospective cohort of 813 AF patients who underwent first-time RFCA was enrolled. The primary outcome was any atrial tachyarrhythmia lasting ≥ 30 s after a 3-month blanking period. Cox regression, ROC curve, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to assess predictive performance.  Results: During 1-year follow-up, 142 patients (17.5%) had recurrent atrial tachyarrhythmia, with significantly higher CHG levels in the recurrence group ( P < 0.001). Each unit increase in the CHG index was associated with a 4.23-fold higher risk of recurrence (HR = 4.231, 95% CI: 3.406–5.257, P < 0.001). The restricted cubic spline curve shows a dose-response relationship between CHG and AF recurrence. The CHG index yielded an AUC of 0.765, superior to TyG (AUC = 0.673). Adding the CHG index to the traditional risk model significantly improved NRI (0.434, P < 0.001) and IDI (0.200, P < 0.001), with greater improvement than adding the TyG index. Subgroup analyses demonstrated consistent predictive effects across different populations.  Conclusions: The CHG index is an independent risk marker for 1-year recurrence after AF ablation and demonstrates superior discriminative ability compared to the TyG index.
SN  - 2297-055X
ER  -