Prognostic value of the CRP–TyG index for in-hospital and 1-year mortality in patients with decompensated heart failure

OBJECTIVE: In heart failure (HF), inflammation and insulin resistance are known to be associated with mortality. C-reactive protein (CRP) reflects systemic inflammation, while the triglyceride-glucose (TyG) index reflects insulin resistance. The combination of these two variables, the CRP-TyG index (CTI), provides an integrated measure of inflammatory-metabolic burden. This study aimed to investigate whether CTI predicts short-term (in-hospital) and mid-term (1-year) mortality in patients with decompensated HF (DHF) admitted to the coronary care unit. METHODS: In this single-center, retrospective study, 170 consecutive patients hospitalized with DHF in the CCU within one year were included. The primary outcomes were in-hospital and 1-year mortality. CTI was calculated from admission laboratory tests using the formula CTI = 0.412 × ln(CRP) + TyG. Patients were classified as "deceased" or "survivor." For short-term outcomes, multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were performed to assess predictive power. RESULTS: In-hospital mortality occurred in 31 patients (18.2%), and 1-year mortality was in 57 patients (33.5%). CTI was significantly higher in both the in-hospital and 1-year mortality groups. In the multivariable model, CTI was identified as an independent predictor of in-hospital mortality (OR 5.31, 95% CI 1.24-22.75; p=0.024), while the prognostic nutritional index was an independent protective factor (OR 0.88, 95% CI 0.82-0.95; p=0.001). ROC analysis for CTI showed an area under the curve (AUC) of 0.79, with an optimal cut-off value of >5.5 (95% CI 0.72-0.84, p