Correlation of Cardiometabolic Index With Premature Coronary Heart Disease and Coronary Artery Disease Severity in Menopausal Women

BACKGROUND: Premature coronary heart disease (PCHD) is a significant health concern. Therefore, this study aimed to examine the association between the cardiometabolic index (CMI) and PCHD, as well as the severity of coronary artery disease, in menopausal women. METHODS: We conducted a retrospective case-control study including 545 menopausal patients who underwent coronary angiography (CAG) between January 2022 and December 2024. Based on the CAG results, patients were classified into the PCHD and control groups. CMI levels were stratified according to quartiles. Logistic regression models and restricted cubic spline regression were used to examine the relationship between CMI levels and PCHD. CHD severity was assessed using the Gensini score (GS). The association between CMI levels and GS was evaluated using Pearson's correlation and linear regression. RESULTS: CMI was significantly and positively associated with PCHD in menopausal women (odds ratio (OR) = 1.21, 95% confidence interval (CI) = 1.07-1.36). After adjustment for several potential confounding factors, patients in the highest CMI quartile (Q4) had a higher risk of PCHD than those in the lowest quartile (Q1) (OR = 1.56, 95% CI = 1.05-2.30). There was a linear dose-response relationship between CMI and PCHD risk (p overall = 0.003, p non-linear = 0.106). Among menopausal patients with PCHD, CMI was positively associated with GS (r = 0.44, p < 0.001), and GS in the Q4 group was, on average, 20.94 points higher than that in Q1 reference group. CONCLUSIONS: In menopausal women, CMI is an independent risk factor for PCHD, and elevated CMI levels are significantly correlated with the severity of coronary artery disease.