Association Between the Composite Nutritional Index TCBI and ISR

Why It Matters

TCBI offers a superior, easily calculated marker to identify patients at heightened ISR risk, enabling more targeted surveillance and preventive strategies in interventional cardiology.

Key Takeaways

• TCBI predicts ISR better than AIP, AC, RC, TyG.
• AUC for TCBI = 0.718 in 454-patient cohort.
• Higher TCBI linked to increased ISR risk independently.
• Uric acid and WBC partially mediate TCBI‑ISR relationship.
• Association holds across diverse clinical subgroups.

Pulse Analysis

In‑stent restenosis continues to undermine the long‑term success of PCI, prompting clinicians to search for reliable predictors beyond traditional angiographic factors. The triglyceride‑total cholesterol‑body weight index (TCBI) merges three readily available laboratory and anthropometric measures—triglycerides, total cholesterol, and body weight—into a single nutritional‑metabolic score. By reflecting both lipid burden and body composition, TCBI captures a dimension of patient health that conventional indices often miss, positioning it as a promising tool for cardiovascular risk assessment.

The recent single‑center study enrolled 454 PCI recipients between January 2022 and January 2024, stratifying them by follow‑up coronary angiography into ISR and non‑ISR groups. Multivariate logistic regression identified elevated TCBI as an independent predictor of restenosis, outperforming the atherogenic index of plasma, atherosclerosis coefficient, residual cholesterol, and triglyceride‑glucose index. With an area under the curve of 0.718, TCBI demonstrated robust discriminative ability. Restricted cubic spline modeling revealed a nonlinear dose‑response, while mediation analysis highlighted uric acid and white‑blood‑cell count as partial conduits linking nutritional status to inflammatory pathways that drive neointimal hyperplasia.

For interventional cardiologists, incorporating TCBI into post‑PCI monitoring could refine risk stratification, allowing earlier imaging or adjunctive pharmacotherapy for high‑risk patients. The index’s reliance on routine labs ensures low implementation cost, but broader validation across diverse populations and integration with existing scoring systems are essential next steps. As the field moves toward personalized cardiovascular care, TCBI exemplifies how metabolic‑nutritional metrics can augment traditional angiographic assessments, potentially reducing ISR‑related morbidity and health‑care expenditures.