Research Article: Association between CRP-TyG index and hepatic synthetic function in post-myocardial infarction ICU patients
Abstract:
To determine whether the CRP–TyG index (CTI)—a composite of systemic inflammation and insulin resistance—is independently associated with early hepatic synthetic function in post–myocardial infarction (MI) ICU patients within 24?h.
Single-center, retrospective cross-sectional study of 286 consecutive post-MI ICU patients (standardized laboratory sampling within 24?h). CTI integrated C-reactive protein with the triglyceride–glucose index. Outcomes were serum albumin (ALB), prealbumin (PA), and the total bilirubin-to-albumin ratio (TBIL/ALB). Associations were estimated using ordinary least squares with prespecified covariate adjustment; nonlinearity was tested using restricted cubic splines. Incremental discrimination was assessed via AUC, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Prespecified subgroups (sex, age ?/>70?years) and sensitivity analyses (excluding deaths, pressor users, CRRT) evaluated robustness.
Higher CTI was independently associated with lower ALB ( ? per unit CTI?=??1.23?g/L, p <?0.001) and PA ( ? =??26.35?mg/L, p <?0.001), but not with TBIL/ALB ( ? =?0.02, p =?0.135). Compared with Q1, Q4 had lower ALB (?2.19?g/L, p =?0.002) and PA (?56.05?mg/L, p <?0.001), with linear dose–response supported by splines (ALB p -overall <0.001; PA p -overall <0.001; nonlinearity p >?0.30). Adding CTI improved discrimination for ALB and PA, but not for TBIL/ALB. Effects were larger in males (per-unit: ALB ?2.16?g/L; PA ?38.92?mg/L) than females (ALB ?0.92?g/L; PA ?15.87?mg/L). Sensitivity analyses excluding deaths, pressor users, or CRRT yielded consistent estimates.
Within 24?h after myocardial infarction surgery, elevated CTI was associated with decreased albumin and prealbumin levels, but not TBIL/ALB ratio. The associations were the same across sex and age categories.
Introduction:
Myocardial infarction (MI) remains a leading cause of morbidity and mortality worldwide. According to reports from the World Health Organization, cardiovascular diseases accounted for approximately 19.8 million deaths in 2022, representing 32% of the total global mortality ( 1 ). Postoperative management in the intensive care unit (ICU) is crucial for patient prognosis, affecting about 48% of patients with acute myocardial infarction (AMI) who require intensive care support ( 2 ). The complex pathophysiological…
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