Predictive value of cardiometabolic index combined with N-Terminal pro-B-Type natriuretic peptide for moderate- to high-risk patients with acute coronary syndrome

To investigate the correlation between the cardiometabolic index (CMI), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and early risk stratification in patients with acute coronary syndrome (ACS), and to evaluate the predictive value of their combination for identifying intermediate- and high-risk patients. A retrospective analysis was conducted on 298 patients with ACS admitted to the Sixth Affiliated Hospital of South China University of Technology from March 2024 to December 2025. According to the Global Registry of Acute Coronary Events (GRACE) score, patients were divided into low-risk (n=209), intermediate-risk (n=67), and high-risk (n=22) groups. Univariate analysis and multiple linear regression were used to explore the associations of CMI and NT-proBNP with early risk. Spearman correlation analysis was applied to examine the correlations of CMI and NT-proBNP with early risk. Receiver operating characteristic (ROC) curves were used to assess the predictive efficacy of CMI combined with NT-proBNP for intermediate- and high-risk patients. Baseline data analysis showed that CMI and NT-proBNP levels in the high-risk group were significantly higher than those in the intermediate- and low-risk groups ( P < 0.001). Spearman correlation analysis indicated that CMI and NT-proBNP were positively correlated with early risk in ACS patients. Multiple linear regression models revealed that CMI and NT-proBNP were independent influencing factors for early risk. The ROC curve showed that the area under the curve (AUC) of CMI combined with NT-proBNP for identifying intermediate- and high-risk patients was 0.782 (95% CI: 0.718–0.847), with an optimal cut-off value of 0.3, a sensitivity of 74.2%, and a specificity of 83.7%. CMI and NT-proBNP are positively correlated with early risk in ACS patients and serve as independent influencing factors. The combination of CMI and NT-proBNP demonstrates good predictive value for intermediate- and high-risk ACS patients.