C-Reactive Protein-Triglyceride Glucose Index Key Predictor of Stroke in Hypertensive Patients, finds study
China: A national study in hypertensive patients revealed an association between elevated C-reactive protein-triglyceride glucose index (CTI) and increased stroke risk. Over 7 years, each one-unit rise in CTI was linked to a 21% higher stroke risk. Patients in the highest CTI quartile had a 66% greater stroke risk compared to those in the lowest quartile.
The researchers suggested that CTI could serve as a valuable predictive marker for stroke in hypertensive patients. The findings were published online in Diabetology & Metabolic Syndrome on November 21, 2024.
Both the triglyceride-glucose (TyG) index, an indicator of insulin resistance (IR), and inflammation are known risk factors for stroke in hypertensive patients. However, few studies have combined the TyG index and inflammation markers to predict stroke risk in this population. The C-reactive protein-triglyceride-glucose index is a new marker that offers a comprehensive assessment of both IR and inflammation severity.
Against the above background, Xin Chen, The Third People’s Hospital of Chengdu, Chengdu, Sichuan, China, and colleagues investigated the relationship between CTI and stroke risk in patients with hypertension.
For this purpose, the researchers recruited 3,834 hypertensive patients without a history of stroke at baseline from the China Health and Retirement Longitudinal Study (CHARLS). To assess the relationship between CTI and stroke risk, they used multivariate Cox regression and restricted cubic spline (RCS) analyses. Additionally, the Boruta algorithm was employed to evaluate the significance of CTI and develop prediction models to forecast stroke incidence in the study cohort.
The study revealed the following findings:
- After 7 years of follow-up, 9.6% of hypertensive patients (368 cases) experienced a stroke.
- Multivariate Cox regression analysis showed that each one-unit increase in CTI was associated with a 21% higher stroke risk (HR = 1.21).
- Patients in the top CTI quartile were 66% more likely to have a stroke compared to those in the bottom quartile (HR = 1.66).
- RCS analysis confirmed a linear relationship between CTI and stroke risk.
- The Boruta algorithm validated CTI as an important predictor of stroke risk.
- The Support Vector Machine (SVM) survival model showed the best predictive performance for stroke risk, with an area under the curve (AUC) of 0.956.
To summarize, the study utilized the CHARLS database and a novel composite indicator of insulin resistance (IR) and inflammation, called CTI, to assess stroke risk in a hypertensive population.
"The results demonstrated a significant link between higher CTI levels and an increased stroke risk, indicating that CTI could serve as a valuable predictive biomarker for stroke in hypertensive patients," the researchers concluded.
Reference:
Tang, S., Wang, H., Li, K. et al. C-reactive protein-triglyceride glucose index predicts stroke incidence in a hypertensive population: a national cohort study. Diabetol Metab Syndr 16, 277 (2024). https://doi.org/10.1186/s13098-024-01529-z
