The cholesterol, high-density lipoprotein, and glucose (CHG) index as a novel metabolic marker for predicting adverse outcomes in myocardial infarction survivors: insights from two large prospective cohorts

Post-myocardial infarction (MI) patients remain at high risk of mortality and recurrent cardiovascular events. Metabolic disorders in patients after MI are closely related to high residual cardiovascular risk. The cholesterol, high-density lipoprotein, and glucose (CHG) index, calculated as Ln {[TC (mg/dL) × FBG (mg/dL)]/[2 × HDL-C (mg/dL)]}, is a recently proposed composite metabolic index. This study aimed to investigate the association between the CHG index and adverse outcomes in MI populations.

This study included two cohorts: 16,959 individuals with a history of MI from the UK Biobank and 6,253 post-MI patients with coronary artery disease from Fuwai Hospital. The primary endpoints in the UK Biobank cohort were all-cause mortality and cardiovascular mortality. In the Fuwai Hospital cohort, the primary endpoint was major adverse cardiovascular events (MACE, including all-cause mortality, non-fatal MI, and ischemia-mediated revascularization) and hard endpoint (including cardiovascular mortality and non-fatal MI). Cox proportional hazards models, Kaplan-Meier curves, and restricted cubic splines (RCS) were used to evaluate the associations between the CHG index and the endpoints. Time-dependent receiver operating characteristic (ROC) curves were employed to assess the predictive performance.