Association between cardiometabolic index and coronary artery calcification in young and middle-aged adults with coronary heart disease.

BACKGROUND

Coronary artery calcification (CAC) serves as a well-established indicator of subclinical atherosclerosis and is a robust predictor of future cardiovascular complications. The cardiometabolic index (CMI), a recently proposed composite metric combining waist-to-height ratio (WHtR) and the triglyceride-to-HDL cholesterol (TG/HDL-C) ratio, has gained attention as a proxy for both visceral fat accumulation and atherogenic dyslipidemia. Nevertheless, the relationship between CMI and CAC in young and middle-aged individuals diagnosed with coronary heart disease (CHD) remains insufficiently explored.

METHODS

This retrospective analysis included CHD patients aged 18-59 years who were admitted to the hospital and underwent coronary computed tomography angiography (CTA) between January 2018 and August 2022. Based on CTA findings, participants were stratified into CAC-positive and CAC-negative groups. Data on demographics, clinical characteristics, and biochemical parameters were obtained. CMI was computed using the formula WHtR × (TG/HDL-C). Multivariate logistic regression models and receiver operating characteristic (ROC) curve analysis were employed to assess both the association and diagnostic value of CMI for CAC.

RESULTS

A total of 439 patients were analyzed, of whom 128 were classified as having CAC. The CAC group exhibited a significantly elevated CMI compared to their counterparts without CAC (P < 0.001). After adjusting for potential confounders, CMI emerged as an independent predictor of CAC (OR = 2.436, 95% CI: 1.694-3.502, P < 0.001), whereas BMI did not reach statistical significance. ROC curve analysis revealed that CMI had superior predictive accuracy relative to BMI (AUC: 0.753 vs. 0.606). The optimal CMI threshold for predicting CAC was 0.742, yielding a sensitivity of 72.81% and a specificity of 70.95%.

CONCLUSION

CMI shows a significant independent association with CAC and outperforms BMI in predicting its presence among young and middle-aged adults with CHD. Given its simplicity, non-invasiveness, and low cost, CMI may represent a practical screening tool for early detection of asymptomatic coronary atherosclerosis in clinical settings.