ACUTE coronary syndrome patients undergoing percutaneous coronary intervention (PCI) with a higher cholesterol, high density lipoprotein, and glucose (CHG) index experienced significantly poorer cardiovascular outcomes, according to a large cohort study involving 23,508 patients.
Researchers found the CHG index was independently associated with an increased risk of major adverse cardiac and cerebrovascular events (MACCE), supporting its potential role in risk stratification after PCI.
The CHG index is a composite measure that integrates total cholesterol, high density lipoprotein cholesterol, and fasting blood glucose.
Although abnormalities in lipid and glucose metabolism are established risk factors in acute coronary syndrome, the prognostic significance of this newer metric in PCI treated populations had not previously been established.
Participants were divided into low and high CHG index groups and followed for clinical outcomes.
During follow up, 2,311 patients experienced at least one adverse event, corresponding to 9.83% of the study population.
Patients in the high CHG index group had significantly higher rates of MACCE compared with those in the low CHG index group (11.24% versus 8.42%).
Rates of major adverse cardiac events, defined as all cause death, non-fatal myocardial infarction, and non-fatal stroke, were also higher in the high CHG group (3.10% versus 2.05%).
Multivariable analysis confirmed the association. When assessed as a continuous variable, a higher CHG index was linked to increased MACCE risk. Similar findings were observed when the index was analysed categorically.
Further analyses showed a linear relationship between CHG index and MACCE risk, with no evidence of non-linearity.
Associations remained consistent across subgroups stratified by factors including age, sex, smoking status, diabetes, hypertension, and body mass index.
No significant interactions were identified.
Researchers also found that incorporating the CHG index into established risk models modestly improved predictive performance for adverse outcomes.
The findings suggest that the CHG index may serve as a practical adjunct to existing assessment tools for identifying patients with acute coronary syndrome at elevated risk following PCI.
However, the researchers noted that the incremental predictive benefit was modest and that further studies are required to clarify its clinical utility.
Reference
Liu Z et al. Cholesterol, HDL, and glucose index and poor prognosis in acute coronary syndrome after PCI: a cohort study. Sci Rep. 2026;DOI:10.1038/s41598-026-73672-8.
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