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已发表论文
代谢和炎症风险对三支血管病变患者围手术期心肌梗死及长期事件预后影响
Authors Song J, Liu Y, Zhou Q, Liu L, Yang X, Wang W
Received 15 July 2025
Accepted for publication 20 October 2025
Published 5 November 2025 Volume 2025:18 Pages 15543—15554
DOI https://doi.org/10.2147/JIR.S553790
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Qing Lin
Jingjing Song,1,* Ye Liu,1,* Qing Zhou,2,3 Lifeng Liu,1 Xiaoyan Yang,1 Wenyao Wang4
1Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China; 3Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 4Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Wenyao Wang, Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, No. 49 Huayuanbei Road, Beijing, 100191, People’s Republic of China, Tel/Fax +86-010-88396171, Email wangwy@bjmu.edu.cn
Purpose: Risk stratification and management of three-vessel coronary artery disease (3VD) remains challenging. Patients with 3VD tolerate greater metabolic and inflammatory burdens than patients with single- and double-vessel coronary artery disease. This study aimed to evaluate the prognostic value of triglyceride-glucose (TyG) index and high-sensitive C-reactive protein (hsCRP), which representing metabolic and inflammatory burdens respectively in a 3VD cohort.
Patients and Methods: This is a retrospective observational study, totally 4495 patients with 3VD were enrolled in the study and divided into 4 groups according to TyG (≥ or < 8.5) and hsCRP (≤ or > 2mg/L). The primary endpoints were periprocedural myocardial infarction (PMI) following percutaneous coronary intervention (PCI) and major adverse cardiovascular events (MACCEs). Restricted cubic spline (RCS), multivariate Cox proportional hazard models, C-index and net reclassification improvement (NRI) were used for analyses.
Results: The median follow-up time was 2.4 years. 3VD patients with TyG≥ 8.5 and hsCRP> 2mg/L exhibited 70%-145% increase risk of PMI according to different definitions. Multivariate Cox regression analyses showed that hsCRP> 2mg/L was associated with approximately 30% increased risk of MACCEs in 3VD patients with TyG≥ 8.5 (HR: 1.31, 95% CI: 1.02– 1.69, p = 0.036) and TyG< 8.5 (HR: 1.31, 95% CI: 1.02– 1.68, p = 0.034) (both p< 0.05). RCS analysis regarding hsCRP as continuous variable found increased hsCRP is positively associated with MACCEs among 3VD patients independent of TyG index (all p< 0.05). Finally, the NRI for PMI (0.38, p< 0.01) and MACCEs (0.16, p< 0.01) were also significantly increased after hsCRP and TyG were added to the baseline model.
Conclusion: 3VD patients with TyG≥ 8.5 and hsCRP> 2mg/L has significantly increased risks of PMI. HsCRP> 2mg/L, alone or in combination of TyG≥ 8.5, has significantly increased risk of MACCEs among 3VD individuals, highlighting the necessity of managing metabolic and inflammatory burdens simultaneously in 3VD patients.
Keywords: three-vessel disease, triglyceride-glucose index, hsCRP, periprocedural myocardial infarction
1Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, People’s Republic of China; 3Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 4Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Wenyao Wang, Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, No. 49 Huayuanbei Road, Beijing, 100191, People’s Republic of China, Tel/Fax +86-010-88396171, Email wangwy@bjmu.edu.cn
Purpose: Risk stratification and management of three-vessel coronary artery disease (3VD) remains challenging. Patients with 3VD tolerate greater metabolic and inflammatory burdens than patients with single- and double-vessel coronary artery disease. This study aimed to evaluate the prognostic value of triglyceride-glucose (TyG) index and high-sensitive C-reactive protein (hsCRP), which representing metabolic and inflammatory burdens respectively in a 3VD cohort.
Patients and Methods: This is a retrospective observational study, totally 4495 patients with 3VD were enrolled in the study and divided into 4 groups according to TyG (≥ or < 8.5) and hsCRP (≤ or > 2mg/L). The primary endpoints were periprocedural myocardial infarction (PMI) following percutaneous coronary intervention (PCI) and major adverse cardiovascular events (MACCEs). Restricted cubic spline (RCS), multivariate Cox proportional hazard models, C-index and net reclassification improvement (NRI) were used for analyses.
Results: The median follow-up time was 2.4 years. 3VD patients with TyG≥ 8.5 and hsCRP> 2mg/L exhibited 70%-145% increase risk of PMI according to different definitions. Multivariate Cox regression analyses showed that hsCRP> 2mg/L was associated with approximately 30% increased risk of MACCEs in 3VD patients with TyG≥ 8.5 (HR: 1.31, 95% CI: 1.02– 1.69, p = 0.036) and TyG< 8.5 (HR: 1.31, 95% CI: 1.02– 1.68, p = 0.034) (both p< 0.05). RCS analysis regarding hsCRP as continuous variable found increased hsCRP is positively associated with MACCEs among 3VD patients independent of TyG index (all p< 0.05). Finally, the NRI for PMI (0.38, p< 0.01) and MACCEs (0.16, p< 0.01) were also significantly increased after hsCRP and TyG were added to the baseline model.
Conclusion: 3VD patients with TyG≥ 8.5 and hsCRP> 2mg/L has significantly increased risks of PMI. HsCRP> 2mg/L, alone or in combination of TyG≥ 8.5, has significantly increased risk of MACCEs among 3VD individuals, highlighting the necessity of managing metabolic and inflammatory burdens simultaneously in 3VD patients.
Keywords: three-vessel disease, triglyceride-glucose index, hsCRP, periprocedural myocardial infarction