Association of the C-reactive protein-triglyceride glucose index with new-onset myocardial infarction risk: a prospective cohort study

This study aimed to investigate the association between the C-reactive protein-triglyceride glucose index (CTI) and risk of new-onset myocardial infarction (MI). We conducted a prospective cohort study among participants enrolled in the Kailuan Study in Tangshan City, Hebei Province, China, who underwent the physical examination between June 2006 and October 2007 (n = 101,510). After applying inclusion and exclusion criteria, 94,509 participants were included in the final analysis.The subjects were stratified into four groups according to baseline CTI quartiles: Q1 (CTI < 7.89), Q2 (7.89 ≤ CTI < 8.54), Q3 (8.54 ≤ CTI < 9.19), and Q4 (CTI ≥ 9.19). New-onset myocardial infarction was the main endpoint of the follow-up, which lasted until December 31, 2021.Hazard ratios (HR) and its 95% confidence interval (CI) were calculated using the multivariate-Cox proportional hazards regression model. The cumulative incidence function was constructed with the Kaplan-Meier method, and log-rank tests were performed to assess between-group differences. During a median follow-up of 15.01 (14.65, 15.20) years, 2,062 new-onset myocardial infarctions were documented. As CTI levels increased, the cumulative incidence rates of MI in the Q1 to Q4 groups were 0.86%, 1.60%, 2.12%, and 3.16%, respectively. After adjusting for relevant confounders, Cox proportional hazards regression analysis showed that compared with the Q1 group, the HR (95% CI) for new-onset myocardial infarction in the Q2 to Q4 groups was 1.42 (95% CI 1.21-1.67), 1.69 (95% CI 1.45-1.98), and 2.04 (95% CI 1.74-2.40), respectively. Each 1-unit increment in CTI was associated with a 29% increase in the risk of new-onset MI. Elevated CTI levels are independently associated with a higher risk of new-onset MI.