Background and Objectives: The coexistence of elevated hs-CRP levels and diabetes mellitus may play an important role in plaque destabilization, favoring plaque rupture and thrombosis, and consequently increasing the risk of coronary artery occlusion and acute coronary syndrome. In this study, we aimed to assess the association of the CRP–glycemia index with coronary artery occlusion at presentation in diabetic patients with ST-segment elevation myocardial infarction (STEMI) and evaluate its potential role as a marker of angiographically confirmed total occlusion. Materials and Methods: In total, 131 consecutive patients presenting with ST-segment elevation myocardial infarction (STEMI) within 12 h of symptom onset who underwent percutaneous coronary intervention (PCI) were included in this study. At patient admission, laboratory assessments were performed, including creatine kinase (CK), CK-MB, troponin I, high-sensitivity C-reactive protein (hs-CRP), glucose, blood urea nitrogen (BUN), creatinine, cholesterol, and standard biochemical parameters. The hs-CRP–glycemia index (CRPGI) was calculated using the following formula: CRPGI = CRP (mg/L) × glucose (mmol/L). Based on the presence of coronary artery occlusion, patients were stratified into two groups: those with acute coronary syndrome and total coronary artery occlusion (ACS/CA–total occlusion (TO), Group 1) and those with ACS and non-total coronary artery occlusion (ACS/CA–non-total occlusion (nTO), Group 2). Results: Of the 131 diabetic patients with STEMI who were treated with PCI, 77 (58.78%) had ACS/CA-TO (Group 1), while 54 (41.22%) had ACS/CA-nTO (Group 2). The CRPGI differed significantly between the groups, p < 0.0001. Significant differences were also observed in glucose, hs-CRP levels, CK, CK-MB, troponin I, and ejection fraction (EF) (p = 0.011, p < 0.0001, p < 0.0001, p < 0.0001, p = 0.004, and p < 0.0001, respectively). Based on binary logistic regression analysis, glucose, and hs-CRP were significantly associated with coronary occlusion, with ORs of 1.115 (p = 0.027), and 1.114 (p < 0.0001), respectively. In the model incorporating the CRPGI, this index was also significantly associated with coronary occlusion (OR, 1.001; 95% CI, 1.000–1.001; p < 0.006). ROC analysis demonstrated the good discriminatory ability of CRPGI, with an AUC of 0.87 (95% CI, 0.80–0.93) and an exploratory optimal threshold of 201.49 (p < 0.0001). Conclusions: The hs-CRP–glycemia index (CRPGI) is associated with angiographically confirmed total coronary artery occlusion in diabetic patients with STEMI, and it may represent a clinically relevant marker accompanying and potentially reflecting the extent of coronary occlusion at the time of presentation.

Background: The coexistence of elevated hs-CRP levels and diabetes mellitus may play a significant role in plaque destabilization, favoring plaque rupture and thrombosis, and consequently increasing the risk of coronary artery occlusion and acute coronary syndrome. Purpose: This study aimed to assess the CRP-glycemia index as potential predictors of of coronary artery occlusion in diabetic patients with acute coronary syndrome. Methods: The study included 131 consecutive patients presenting with ST-segment elevation myocardial infarction (STEMI) within 12 hours of symptom onset who underwent percutaneous coronary intervention (PCI). At admission, laboratory assessments were performed, including creatine kinase (CK), CK-MB, troponin I, high-sensitivity C-reactive protein (hs-CRP), glucose, blood urea nitrogen (BUN), creatinine, cholesterol, and standard biochemical parameters. The CRP–glycemia index (CRPGI) was calculated using the formula: CRPGI = CRP (mg/L) × glucose (mmol/L). Based on the presence of coronary artery occlusion, patients were stratified into two groups: those with acute coronary syndrome and total coronary artery occlusion (ACS/CA-total occlusion (TO), Group 1) and those with ACS and non-total coronary artery occlusion (ACS/CA-non-total occlusion (nTO), Group 2). Results: Of the 131 diabetic patients with STEMI treated with PCI, 77 (58.77) had ACS/CA-TO (Group 1), while 54 (41.22%) had ACS/CA-nTO (Group 2) (Table 1). CRPGI differed significantly between the groups, p<0.0001. Significant differences were also observed in glucose, hs-CRP levels, CK, CK-MB, troponin I, and ejection fraction (EF) (p=0.011, p<0.0001, p<0.0001, p<0.000, p=0.004 and p<0.0001, respectively). Based on binary logistic regression, we analyzed the relationship between one dichotomous dependent variable (ACS/CA-TO or ACS/CA-nTO) and other variables (age hypertension, BMI, diabetes mellitus, smoking, glucose, hs-CRP, and CRP–glycemia index (CRPGI). Glucose, hs-CRP, and CRPGI are significant predictors at the 5% level, with p-values of 0.007, <0.0001 and <0.0001 respectively (Table 2). The ROC analysis of the CRPGI demonstrates an AUC of 0.87 (95% CI: 0.80–0.93), with an optimal threshold of 201.49 (p < 0.0001) (Table 3). Table 3 further summarizes the AUCs for the other biomarkers included in the study. Figure 1 presents the ROC curve analyses for the studied biomarkers, showing a progressive increase in predictive significance from glucose to CRP and finally to the CRP–glycemia index (CRPGI). Conclusions: The CRP–glycemia index (CRPGI) appears to be a valuable predictor of coronary artery occlusion in diabetic patients with STEMI, highlighting its potential utility for risk stratification and early clinical assessment.