The Relationship Between the C-reactive Protein-Triglyceride Glucose Index and the Risk of Coronary Heart Disease Alongside the Severity of Coronary Artery Stenosis in Older Adults With Different Levels of Glucose Metabolism: A Real-World Retrospective Clinical Study.

Background: Coronary heart disease (CHD), one of the most severe cardiovascular conditions, poses a significant threat to the health and survival of older adults. Numerous studies have confirmed that diabetes, inflammation, and dyslipidemia are key risk factors for CHD. However, the relationship between the C-reactive protein-triglyceride glucose index (CTI) and CHD risk in older adults across different glucose metabolism statuses remains unexplored. Thus, this study aimed to investigate the correlation between the CTI and CHD risk in older adults with varying glycemic statuses. Methods: Patients aged ≥60 years, who underwent coronary angiography between January 2019 and December 2023, were enrolled. A diagnosis of CHD was performed when the coronary angiography demonstrated ≥50% stenosis in at least one major epicardial vessel. Demographic characteristics, medical history, laboratory data, and procedural records were systematically collected. Least absolute shrinkage and selection operator (Lasso) and multivariate logistic regression identified potential predictors. Receiver operating characteristic (ROC) curves were employed to assess the clinical value of CTI in predicting CHD risk. A restricted cubic spline (RCS) was used to examine all nonlinear relationships. A nomogram for the occurrence of CHD in older adults was constructed, and a subgroup analysis was performed. Results: A total of 1204 patients were included (919 diagnosed with CHD, 285 non-CHD (NCHD) controls). The CTI was identified as an independent risk factor for CHD (odds ratio (OR) = 4.88, 95% confidence interval (CI): 3.59-6.62). The CTI, analyzed both as a continuous and categorical variable, showed significant associations with CHD incidence across various adjusted models. The RCS analysis across different glucose metabolism statuses revealed a nonlinear relationship between the CTI and coronary artery stenosis severity in the overall population. The nomogram model based on multivariate logistic regression demonstrated good predictive accuracy for CHD in older adults. Conclusion: A positive correlation exists between the CTI and both CHD risk and the severity of coronary stenosis in older adults.