Association between C-reactive protein to triglyceride-glucose index and atrial fibrillation: a cross-sectional analysis.

CTI levels were significantly higher in the AF group compared to the non-AF group in a cross-sectional sample of 2,988 adult participants.

• The study included 2,988 participants with clinical and laboratory data collected to calculate the CTI.
• CTI is described as a novel composite biomarker combining C-reactive protein and the triglyceride-glucose index.
• The comparison between AF and non-AF groups was a primary descriptive finding of the study.
• The study design was cross-sectional, limiting causal inference.

CTI was independently and positively associated with AF prevalence in a fully adjusted multivariable logistic regression model.

• In the fully adjusted model, OR was 7.27 (95% CI 5.87–9.00; P < 0.001).
• Covariates adjusted for included age, sex, BMI, blood pressure, glycemic indices, and lipid profiles.
• The association remained significant after multivariable adjustment, indicating independence from traditional cardiovascular risk factors.
• Multiple logistic regression models were employed to evaluate the association.

Restricted cubic spline analysis revealed a significant linear dose-response relationship between CTI and AF risk.

• RCS analysis was used to assess the shape of the dose-response relationship between CTI and AF.
• The relationship was described as 'significant linear,' suggesting no threshold or nonlinear effect.
• This finding supports a continuous, graded association between CTI levels and AF prevalence.

Adding CTI to the reference clinical model significantly improved AF risk discrimination and reclassification.

• The C-index improved from 0.6828 to 0.7985 when CTI was added to the reference clinical model.
• Net reclassification improvement (NRI) was 0.5609 (P < 0.001).
• Integrated discrimination improvement (IDI) was 0.7182 (P < 0.001).
• All improvements in C-index, NRI, and IDI were statistically significant at P < 0.001.

The CTI was proposed as a valuable integrative biomarker for identifying individuals at high risk for atrial fibrillation.

• CTI reflects a state of combined elevated inflammation and insulin resistance.
• The authors characterize CTI as a 'novel and integrative biomarker' capturing two pathophysiological pathways relevant to AF.
• The study suggests CTI may serve a clinical role in AF risk stratification in the general adult population.