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

## TL;DR

This study finds that a new biomarker, CTI, is strongly linked to a higher risk of atrial fibrillation, suggesting it could help identify high-risk individuals.

## Contribution

The study introduces CTI as a novel composite biomarker for predicting atrial fibrillation risk.

## Key findings

- CTI levels were significantly higher in participants with atrial fibrillation compared to those without.
- CTI showed a strong independent association with AF prevalence in fully adjusted models.
- Adding CTI to clinical models improved risk prediction metrics like C-index, NRI, and IDI.

## Abstract

This study aimed to investigate the association between a novel composite biomarker, the C-reactive protein to triglyceride-glucose index (CTI) and the prevalence of atrial fibrillation (AF) in a general adult population.

This cross-sectional study included 2, 988 participants Clinical and laboratory data were collected to calculate the CTI. Multivariable logistic regression models were employed to evaluate the association between CTI and AF prevalence, and the dose–response relationship was assessed using restricted cubic spline (RCS) analysis. Furthermore, the association between CTI and AF risk was evaluated using the C-index, net reclassification improvement (NRI), and integrated discrimination improvement (IDI).

Among the 2, 988 participants, CTI levels were significantly higher in the AF group compared to the non-AF group. In the fully adjusted model (adjusting for age, sex, BMI, blood pressure, glycemic indices, and lipid profiles), CTI was independently and positively associated with AF prevalence (OR 7.27, 95% CI 5.87–9.00; P < 0.001). Restricted cubic spline analysis revealed a significant linear dose-response relationship between CTI and AF risk. Furthermore, adding CTI to the reference clinical model improved the C-index from 0.6828 to 0.7985, accompanied by significant improvements in the net reclassification improvement (NRI: 0.5609) and integrated discrimination improvement (IDI: 0.7182) (all P < 0.001).

A higher CTI, reflecting a state of combined elevated inflammation and insulin resistance, is significantly and independently associated with an increased prevalence of atrial fibrillation. This novel index may serve as a valuable and integrative biomarker for identifying individuals at high risk for AF.