C-Reactive Protein-Triglyceride Glucose Index and Mortality in Patients with Ventricular Septal Rupture After Acute Myocardial Infarction.

BACKGROUND: Ventricular septal rupture (VSR) is a life-threatening complication of acute myocardial infarction (AMI). The C-reactive protein-triglyceride glucose index (CTI) integrates insulin resistance (IR) and inflammation. The present study was designed to investigate the correlation between CTI and 1-year all-cause mortality in VSR patients after AMI. METHODS: 284 VSR patients were consecutively enrolled at Fuwai Central China Cardiovascular Hospital between January 2018 and April 2025. According to the median CTI value (6.408), the 284 VSR patients were divided into two groups. The relationship between CTI and clinical outcomes was evaluated using multivariate logistic regression analysis, followed by mediation analysis to explore indirect statistical associations. RESULTS: 1-year all-cause mortality in VSR patients was 71.8% (204/284). The mortality of the high CTI group was significantly higher than that of the low CTI group (87.3% vs 56.3%, P < 0.001). Multivariate logistic regression analysis revealed that CTI was associated with mortality (OR = 2.89, 95% CI: 1.85-4.51, P < 0.001), with mortality showing an upward trend as CTI levels increased (P < 0.001). Mediation analyses identified indirect statistical associations involving neutrophil count and NT-proBNP, with mediation proportions of 65.8% and 35.3%, respectively (both P < 0.05). CONCLUSION: CTI is associated with mortality but not independently, with indirect statistical associations involving inflammation and increased cardiac load.