Association between elevated C-reactive protein-triglyceride-glucose index and in-hospital major adverse cardiovascular events in acute coronary syndrome patients after percutaneous coronary intervention: a single-center prospective observational study.

Objective: Inflammation and metabolic disorders play important roles in the pathogenesis of acute coronary syndrome(ACS). The C-reactive protein-triglyceride-glucose index(CTI) is a novel combined inflammatory-metabolic indicator. This study aimed to evaluate the association between CTI and in-hospital major adverse cardiovascular events(MACE) in ACS patients after percutaneous coronary intervention(PCI). Methods: This prospective observational study consecutively enrolled 300 patients who underwent PCI for ACS at our hospital from January 2023 to October 2025. C-reactive protein(CRP),triglyceride(TG), and fasting plasma glucose (FPG) were measured upon admission, and CTI values were calculated. Patients were divided into Q1-Q4 groups according to CTI quartiles. The primary endpoint was in-hospital MACE, defined as a composite of cardiac death, acute stent thrombosis, recurrent myocardial infarction, acute heart failure, and cardiogenic shock. Multivariate logistic regression analysis was used to assess the association between CTI and in-hospital MACE. Results: Among the 300 patients, 73 (24. 3%) experienced in-hospital MACE. Compared with the Q1 group, patients in the Q4 group had significantly higher incidence of MACE (10. 7% vs 44. 0%, P<0. 001). Multivariate analysis showed that, after adjusting for traditional risk factors, the highest CTI quartile group(Q4) remained significantly associated with MACE risk (adjusted OR 3. 28, 95%CI 1. 42-7. 56, P , 0. 005). For each standard deviation increase in CTI, the risk of MACE increased by 46% (OR 1. 46, 95%CI 1. 21-1. 76, P<0. 001). CTI demonstrated better predictive value for MACE (AUC, 0. 703, 95%CI 0. 641-0. 766) compared to CRP (AUC, 0. 610), TG (AUC, 0. 655), or FPG (AUC, 0. 678) alone (all P<0. 05). Subgroup analysis showed that CTI had stronger predictive ability in patients with ST-segment elevation myocardial infarction, diabetes, and multivessel disease. Conclusion: Elevated CTI levels after PCI in ACS patients are significantly associated with increased risk of in-hospital MACE. CTI may be an effective tool for evaluating short-term prognosis in ACS patients after PCI, providing reference for early risk stratification and enhanced monitoring.