Abstract
BACKGROUND: Cholesterol, high-density lipoprotein, and glucose (CHG) index, an alternative marker of insulin resistance (IR), play a significant role in predicting cardiovascular diseases. However, its prognostic value in patients with calcific aortic valve stenosis (CAVS) remains unclear. METHODS: This study included 1175 patients diagnosed with calcific aortic valve stenosis via echocardiography from the First Affiliated Hospital of Sun Yat-sen University. Participants were grouped based on the cut-off value of the CHG index. The association between the CHG index and cardiovascular mortality and all-cause mortality in patients with calcific aortic valve stenosis was evaluated using Cox proportional hazards regression and restricted cubic model spline. RESULTS: Among the 1175 patients (mean age 68.91 ± 11.68 years, 56.6% male), the median follow-up time was 3.23 [1.15, 6.07] years. In the fully adjusted model, each 1-unit increase in the CHG index was linked to a 53% higher risk of cardiovascular mortality and a 43% higher risk of all-cause mortality. Moreover, compared to the low CHG index group, the high CHG index group had a 1.44-fold higher risk of cardiovascular mortality and a 1.43-fold higher risk of all-cause mortality. The restricted cubic spline model indicated a linear relationship between the CHG index and the risks of cardiovascular mortality (p for nonlinearity = 0.529) and all-cause mortality (p for nonlinearity = 0.436). CONCLUSION: Higher levels of insulin resistance, as assessed by the CHG index, are associated with increased risks of cardiovascular and all-cause mortality in patients with calcific aortic valve stenosis. TRIAL REGISTRATION: RISk facTOr assessmenT and prognosis modeL construction (ARISTOTLE) study (Registry: ClinicalTrials.gov, TRN: NCT06069232, Registration date: 1 October 2023).