# Bootstrap-Augmented Analysis of Non-Linear Associations Between Glucose, hsCRP, and First Myocardial Infarction in a Cardiovascular Population

## TL;DR

The study finds that glucose and hsCRP levels have non-linear relationships with first heart attacks in cardiovascular patients.

## Contribution

A bootstrap-augmented approach reveals non-linear associations between glucose, hsCRP, and first MI events.

## Key findings

- Glucose and hsCRP levels show the strongest discrimination between MI(+) and MI(−) groups.
- Non-linear associations are most pronounced in lower and intermediate quartiles of these variables.
- Bootstrap validation confirms the stability of these non-linear effects.

## Abstract

Myocardial infarction (MI) remains one of the most severe acute cardiac events, despite significant progress in diagnostics and therapy. Early identification of patients at risk within the broader cardiovascular disease (CVD) population is crucial for prevention and management. This study aimed to characterize the nonlinear distributions of glucose and high-sensitivity C-reactive protein (hsCRP) in patients experiencing their first MI compared with individuals hospitalized for other CVD conditions, using a bootstrap-augmented analytical approach. This retrospective study included 743 adults with confirmed CVD. Biochemical variables, including lipid profile, glucose, hsCRP, and estimated glomerular filtration rate (eGFR), were analyzed in relation to the occurrence of MI. Statistical analyses were supported by bootstrap-based validation to ensure the robustness of findings. Among the examined variables, serum glucose and hsCRP levels showed the strongest ability in discriminating MI(+) and MI(−) groups. Both variables exhibited complex, non-linear associations with the occurrence of MI, with the most pronounced differences observed in the lower and intermediate quartiles. Bootstrap-supported analyses confirmed the stability of these effects. In CVD patients, both blood glucose and hsCRP levels display non-linear relationships with the first occurrence of MI. The strongest distinctions between MI(+) and MI(−) groups were found at moderate concentrations of these variables, emphasizing the need for cautious interpretation and highlighting their role in characterizing biochemical patterns in MI(+) and MI(−) patients.