BMC Neurology · Published 2026-07-15 · DOI 10.1186/s12883-026-05141-8
Liye Dai, Yiting Sun, Jinfeng Yin, Yong Jiang, Hao Li, Yongjun Wang, Xia Meng
Abstract Background The high-sensitivity C-reactive protein-triglyceride glucose index (hsCTI) is an integrated biomarker reflecting systemic inflammation and insulin resistance. This study aimed to evaluate the association between hsCTI levels and the risk of stroke recurrence in a large, real-world cohort. Methods We analyzed data from the China National Stroke Registry-III, including patients with acute ischemic stroke or transient ischemic attack (TIA). The hsCTI was calculated as 0.412 × ln(hsCRP [mg/L]) + ln(TG [mg/dL] × FPG [mg/dL]/2). Outcomes included stroke recurrence, ischemic stroke recurrence, and composite vascular events. Kaplan-Meier curves and Cox proportional hazards models were employed to evaluate the association between hsCTI and clinical outcomes, stratified by sex, age, and glycemic status. The area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated to evaluate the incremental risk prediction capabilities of hsCTI and TyG index beyond traditional risk factors. Results Among 4,969 included patients (67.8% male), those in the highest hsCTI quartile (Q4) experienced increased risks of recurrent stroke and composite vascular events during a maximum follow-up of 5 years. Compared with the lowest quartile, Q4 was associated with significantly elevated 3-month stroke recurrence (adjusted hazard ratio [aHR], 1.83; 95% CI, 1.23–2.73) and composite vascular events (aHR, 2.04; 95% CI, 1.38-3.00), with associations remaining significant at 1 year. The prognostic value was most pronounced in individuals aged ≥ 60 years. Subgroup analyses identified significant interactions between hsCTI and age (P for interaction = 0.009), as well as National Institutes of Health Stroke Scale (NIHSS) score at admission (P for interaction = 0.017). Adding hsCTI to the reference model significantly improved clinical risk prediction (all P < 0.001for NRI and IDI). Conclusions Elevated baseline hsCTI level was associated with an increased risk of stroke recurrence and composite vascular events. HsCTI may serve as a potential biomarker for identifying residual vascular risks.
Abstract from DOAJ. Public domain (CC0 1.0).
Read the article at the publisher →
Dai, L., Sun, Y., Yin, J., et al. (2026). Association of high-sensitivity C-reactive protein-triglyceride glucose index and stroke outcomes: results from the China National Stroke Registry III. BMC Neurology. https://doi.org/10.1186/s12883-026-05141-8