Association of C-reactive protein–triglyceride–glucose index with coronary microvascular dysfunction in patients without obstructive coronary artery disease
- 1Department of Cardiology, The Affiliated Hospital of Qingdao University
Abstract
Background: Patients with angina symptoms and no obstructive coronary lesions may have coronary microvascular dysfunction (CMD). The C–reactive protein–triglyceride–glucose index(CTI) is a novel metabolic-inflammatory marker, but its value in CMD remains unclear. This study aimed to evaluate the association of metabolic indices with CMD and determine the incremental value of CTI compared with other metabolic indices.
Methods: This retrospective cohort study included 129 patients without obstructive coronary artery disease who underwent stress echocardiography after coronary angiography. The associations of CTI, triglyceride–glucose (TyG) index, TyG–Body mass index (TyG–BMI), remnant cholesterol–inflammation index (RCII), and metabolic score for insulin resistance (METS–IR) with CMD were evaluated using correlation analyses and multivariable logistic regression models. ROC curve analysis and DeLong tests were performed to compare predictive performance among metabolic indices, while restricted cubic spline analyses and subgroup analyses were conducted to assess dose–response relationships and the robustness of the associations.
Results: Among 129 patients, 64 (49.6%) had CMD. CTI was negatively correlated with coronary flow reserve ( r = −0.490, P < 0.001) and remained independently associated with CMD after multivariable adjustment (OR: 2.472, 95% CI: 1.480–4.128). CTI showed the best predictive performance among the evaluated metabolic indices (AUC: 0.730, 95% CI: 0.644–0.817), with significant improvement in risk classification (NRI = 0.541, P = 0.010). Higher CTI levels were associated with increased CMD prevalence, and the association remained consistent across most subgroups.
Conclusion: CTI is strongly associated with CMD and provides incremental value for CMD risk stratification beyond conventional metabolic indices. CTI may serve as a promising metabolic-inflammatory biomarker for identifying individuals with CMD.
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BibTeX
@article{wu2026association,
title = {{Association of C-reactive protein–triglyceride–glucose index with coronary microvascular dysfunction in patients without obstructive coronary artery disease}},
author = {YanZhou Wu and Yi An and XiaoHan Liu and RuTing Li and Rui Zhang and Cong Zhao and DongPeng Li},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = nov,
doi = {10.3389/fcvm.2026.1961494},
url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1961494/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association of C-reactive protein–triglyceride–glucose index with coronary microvascular dysfunction in patients without obstructive coronary artery disease
AU - YanZhou Wu
AU - Yi An
AU - XiaoHan Liu
AU - RuTing Li
AU - Rui Zhang
AU - Cong Zhao
AU - DongPeng Li
PY - 2026
DA - 2026/11/02
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1961494
UR - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1961494/full
AB - Background: Patients with angina symptoms and no obstructive coronary lesions may have coronary microvascular dysfunction (CMD). The C–reactive protein–triglyceride–glucose index(CTI) is a novel metabolic-inflammatory marker, but its value in CMD remains unclear. This study aimed to evaluate the association of metabolic indices with CMD and determine the incremental value of CTI compared with other metabolic indices. Methods: This retrospective cohort study included 129 patients without obstructive coronary artery disease who underwent stress echocardiography after coronary angiography. The associations of CTI, triglyceride–glucose (TyG) index, TyG–Body mass index (TyG–BMI), remnant cholesterol–inflammation index (RCII), and metabolic score for insulin resistance (METS–IR) with CMD were evaluated using correlation analyses and multivariable logistic regression models. ROC curve analysis and DeLong tests were performed to compare predictive performance among metabolic indices, while restricted cubic spline analyses and subgroup analyses were conducted to assess dose–response relationships and the robustness of the associations. Results: Among 129 patients, 64 (49.6%) had CMD. CTI was negatively correlated with coronary flow reserve ( r = −0.490, P < 0.001) and remained independently associated with CMD after multivariable adjustment (OR: 2.472, 95% CI: 1.480–4.128). CTI showed the best predictive performance among the evaluated metabolic indices (AUC: 0.730, 95% CI: 0.644–0.817), with significant improvement in risk classification (NRI = 0.541, P = 0.010). Higher CTI levels were associated with increased CMD prevalence, and the association remained consistent across most subgroups. Conclusion: CTI is strongly associated with CMD and provides incremental value for CMD risk stratification beyond conventional metabolic indices. CTI may serve as a promising metabolic-inflammatory biomarker for identifying individuals with CMD.
SN - 2297-055X
ER -