Association between cholesterol, high-density lipoprotein, and glucose index and risks of cardiovascular and all-cause mortality in patients with calcific aortic valve stenosis: the ARISTOTLE cohort study

Cholesterol, high-density lipoprotein, and glucose (CHG) index, an alternative marker of insulin resistance (IR), play a significant role in predicting cardiovascular diseases. However, its prognostic value in patients with calcific aortic valve stenosis (CAVS) remains unclear. This study included 1175 patients diagnosed with calcific aortic valve stenosis via echocardiography from the First Affiliated Hospital of Sun Yat-sen University. Participants were grouped based on the cut-off value of the CHG index. The association between the CHG index and cardiovascular mortality and all-cause mortality in patients with calcific aortic valve stenosis was evaluated using Cox proportional hazards regression and restricted cubic model spline. Among the 1175 patients (mean age 68.91 ± 11.68 years, 56.6% male), the median follow-up time was 3.23 [1.15, 6.07] years. In the fully adjusted model, each 1-unit increase in the CHG index was linked to a 53% higher risk of cardiovascular mortality and a 43% higher risk of all—cause mortality. Moreover, compared to the low CHG index group, the high CHG index group had a 1.44—fold higher risk of cardiovascular mortality and a 1.43-fold higher risk of all-cause mortality. The restricted cubic spline model indicated a linear relationship between the CHG index and the risks of cardiovascular mortality (p for nonlinearity = 0.529) and all-cause mortality (p for nonlinearity = 0.436). Higher levels of insulin resistance, as assessed by the CHG index, are associated with increased risks of cardiovascular and all-cause mortality in patients with calcific aortic valve stenosis. RISk facTOr assessmenT and prognosis modeL construction (ARISTOTLE) study (Registry: ClinicalTrials.gov, TRN: NCT06069232, Registration date: 1 October 2023).