Supplementary file 1_Association between CRP-TyG index and hepatic synthetic function in post-myocardial infarction ICU patients.docx

ObjectiveTo determine whether the CRP–TyG index (CTI)—a composite of systemic inflammation and insulin resistance—is independently associated with early hepatic synthetic function in post–myocardial infarction (MI) ICU patients within 24 h.
MethodsSingle-center, retrospective cross-sectional study of 286 consecutive post-MI ICU patients (standardized laboratory sampling within 24 h). CTI integrated C-reactive protein with the triglyceride–glucose index. Outcomes were serum albumin (ALB), prealbumin (PA), and the total bilirubin-to-albumin ratio (TBIL/ALB). Associations were estimated using ordinary least squares with prespecified covariate adjustment; nonlinearity was tested using restricted cubic splines. Incremental discrimination was assessed via AUC, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Prespecified subgroups (sex, age ≤/>70 years) and sensitivity analyses (excluding deaths, pressor users, CRRT) evaluated robustness.
ResultsHigher CTI was independently associated with lower ALB (β per unit CTI = −1.23 g/L, p < 0.001) and PA (β = −26.35 mg/L, p < 0.001), but not with TBIL/ALB (β = 0.02, p = 0.135). Compared with Q1, Q4 had lower ALB (−2.19 g/L, p = 0.002) and PA (−56.05 mg/L, p < 0.001), with linear dose–response supported by splines (ALB p-overall <0.001; PA p-overall <0.001; nonlinearity p > 0.30). Adding CTI improved discrimination for ALB and PA, but not for TBIL/ALB. Effects were larger in males (per-unit: ALB −2.16 g/L; PA −38.92 mg/L) than females (ALB −0.92 g/L; PA −15.87 mg/L). Sensitivity analyses excluding deaths, pressor users, or CRRT yielded consistent estimates.
ConclusionWithin 24 h after myocardial infarction surgery, elevated CTI was associated with decreased albumin and prealbumin levels, but not TBIL/ALB ratio. The associations were the same across sex and age categories.