The Journal of Practical Medicine >

2025 , Vol. 41 >Issue 7: 1010 - 1017

DOI: https://doi.org/10.3969/j.issn.1006-5725.2025.07.012

Clinical Research

Association between coronary inflammation and malnutrition on prognosis in patients with coronary artery disease

  • Lulin CHEN ,
  • Tingjie YANG ,
  • Meng SUN ,
  • Xin LI ,
  • Yiming GUO ,
  • Yuqing YANG ,
  • Yudong CAO ,
  • Wenzhe LI ,
  • Jiangshu YUAN ,
  • Honghui YANG
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  • *.Department of Cardiology，Central China Fuwai Hospital of Zhengzhou University，Fuwai Central China Cardiovascular Hospital，Zhengzhou 451464，Henan，China

Received date: 2024-12-25

  Online published: 2025-04-23

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Abstract

Objective This study aimed to investigate the relationship between malnutrition and coronary inflammation， and explore the interaction and mediating effects of coronary inflammation in the association between malnutrition and major adverse cardiovascular events （MACE）. Methods A retrospective analysis was conducted on 428 patients diagnosed with coronary heart disease at the Central China Fuwai Hospital from May 2018 to July 2022. All patients underwent coronary angiography （CAG） and coronary computed tomography angiography （CCTA）. The TCB index （triglycerides × total cholesterol × body weight） and the coronary fat attenuation index around the proximal right coronary artery （RCA?FAI） were used to assess patients' nutritional state and the degree of coronary inflammation， respectively.The study endpoint was MACE. We used linear regression models to analyze the correlation between TCBI and RCA?FAI， cox regression models to assess the correlation of TCBI and RCA?FAI with MACE， and mediation analysis to investigate whether RCA?FAI mediated the relationship between TCBI and MACE. Results A total of 428 patients were included in the study. There was a negative correlation between RCA?FAI and TCBI （r = -0.224， P < 0.001）. After adjusting for potential confounders， each standard deviation decrease in the TCBI index was associated with a 2.20 HU increase in RCA?FAI （95% CI： -3.40 ~ -1.19， P < 0.001）. During a mean follow?up period of 2.15 years， 51 MACE occurred. MACE risk in the low TCBI/high RCA?FAI group was 6.58 times higher than that in the high TCBI/low RCA?FAI group （adjusted HR = 6.580， 95%CI： 2.237 ~ 19.360， P = 0.001）， and the interaction between TCBI and RCA?FAI was identified.Mediation analysis revealed that RCA?FAI mediated 37.5% of the associations between TCBI and MACE. Conclusions In patients with coronary artery disease， malnutrition is associated with increased coronary inflammation. There is a significant interaction between malnutrition and coronary inflammation in the risk of MACE， and coronary inflammation partially mediates the relationship between malnutrition and MACE. The combination of the TCBI index and RCA?FAI can help identify patients at high cardiovascular risk. Improving malnutrition and controlling coronary inflammation may provide additional benefits for patients with coronary artery disease.

Key words： coronary inflammation; nutritional index; malnutrition; major adverse cardiovascular events

Cite this article

Lulin CHEN , Tingjie YANG , Meng SUN , Xin LI , Yiming GUO , Yuqing YANG , Yudong CAO , Wenzhe LI , Jiangshu YUAN , Honghui YANG . Association between coronary inflammation and malnutrition on prognosis in patients with coronary artery disease[J]. The Journal of Practical Medicine, 2025 , 41(7) : 1010 -1017 . DOI: 10.3969/j.issn.1006-5725.2025.07.012

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