The influence of C-reactive protein-triglyceride-glucose index (CTI) on the prognosis of heart failure patients with different ejection fractions.

Abstract

The C-reactive protein-triglyceride-glucose index (CTI) is a novel biomarker integrating inflammation and insulin resistance. Its prognostic value for all-cause mortality in patients with chronic heart failure (CHF) across the ejection fraction (EF) spectrum remains unclear. Patients were categorized into low- and high-CTI groups based on a restricted cubic spline-derived cutoff. Kaplan-Meier curves were used to compare survival, and Cox proportional hazards models were used to assess the association between CTI and all-cause mortality. Receiver operating characteristic (ROC) analysis and subgroup analyses were performed. A total of 1,130 patients with CHF were included. Kaplan-Meier survival analysis showed that patients with elevated CTI levels had a significantly higher risk of all-cause mortality compared to those with lower CTI levels. Multivariable-adjusted Cox proportional hazards analysis further confirmed that CTI levels were independently associated with increased all-cause mortality. Subgroup analysis demonstrated that elevated CTI levels were associated with higher all-cause mortality in patients with heart failure with reduced ejection fraction (HFrEF) and mildly reduced ejection fraction (HFmrEF). CTI is an independent prognostic marker for all-cause mortality in patients with CHF across different EF subtypes and may serve as a useful risk stratification biomarker.