hs-CRP-TyG Index as Marker of CAD Severity and Inflammation-Metabolic Risk: Study
The hs-CRP-TyG index is linked to both the presence and severity of coronary artery disease (CAD), reflecting the combined impact of inflammation and metabolic dysfunction. Although it is more sensitive than the TyG index alone, its overall ability to discriminate CAD risk is similar, with limited added predictive benefit after full adjustment for other risk factors. Its complementary value in high-risk populations may therefore be modest, and further prospective studies are needed to confirm its clinical usefulness. The study was published in the Frontiers in Endocrinology journal by Yang M and colleagues.
A detailed assessment of the diagnostic accuracy of this novel index was accomplished by performing an extensively validated retrospective cohort study from a special registry for cardiac care. The authors recruited 1,372 consecutively identified patients who underwent coronary angiography to examine the structural state of their coronary arteries. In accordance with their imaging findings, all study participants were subsequently stratified to either a main case cohort comprising of 1,190 participants with diagnosed CAD or a control cohort comprising of 182 participants without evidence of any coronary arterial disease according to angiography results.
Fasting blood sugar, serum triglyceride, and hs-CRP concentrations were measured in every patient to determine their personal baseline hs-CRP-TyG values. The mathematical relationships between the index and CAD risks were determined by applying multivariable logistic regression in four progressively adjusted statistical models. Model stability was assessed using ROC curves through the use of the DeLong test, calibration plot, and bootstrap internal validation with 1,000 repetitions. Non-linear dose-response relationships were explored using RCS analysis, while DCA estimated actual clinical usefulness.
Key findings:
- Median hs-CRP-TyG values were found to be significantly elevated among those patients with CAD at 1.45 (IQR: 1.02 – 1.90) compared to a lower median baseline among the controls without CAD at 1.23 (IQR: 0.89 -1.69) (P < 0.01).
- As per the fully adjusted multivariable model (Model 4), each standard unit increment in the hs-CRP-TyG score was independently associated with a 34% increased CAD risk (Odds Ratio [OR] = 1.34, CI: 1.03 -1.78, P < 0.05).
- Analysis based on restricted cubic splines revealed a nonlinear relationship indicating an increased and steeper risk of CAD when a patient's hs-CRP-TyG level exceeded a threshold level of 1.42.
- The sensitivity of the combined hs-CRP-TyG index was found to be 68%, which was considerably greater than the sensitivity of 47% observed in the TyG index alone.
- However, the overall area under the curve (AUC) measure was found to be equal for both indices (AUC: 0.79 vs. 0.79; DeLong test P > 0.05).
- Further, NRI and IDI analysis indicated that addition of hs-CRP to the TyG index yielded minimal net reclassification gain after full adjustment for established risk factors.
Conclusively, hs-CRP-TyG index is linked to the occurrence as well as the progression of CAD since it takes into account the metabolic and inflammatory actions. Even though it has superior sensitivity compared to TyG alone, their overall discriminatory power and incremental contribution are similar once fully adjusted. In all, these results offer a realistic context for modern cardiology practice, where combining two biomarkers gives us more insight into the disease process but may not necessarily substitute established risk stratification methods.
Reference:
Yang, Min, et al. "Association of the hs-CRP-TyG Index With Coronary Artery Disease Risk and Angiographic Severity: a Retrospective Comparative Study With the TyG Index." Frontiers in Endocrinology, vol. 17, 2026, p. 1836149.
