Objective:

To examine the association of the C-reactive protein–triglyceride–glucose index (CTI) with coronary heart disease (CHD) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and to develop a nomogram for CHD assessment.

Approach:

• Data Analysis: Logistic regression assessed the association between CTI and CHD, followed by subgroup and restricted cubic spline analyses. Receiver operating characteristic (ROC) analysis compared CTI's performance with other indices.

Key Findings:

• 387 out of 611 patients (63.3%) had CHD.
• CTI was independently associated with CHD (OR 2.48, 95% CI 1.69–3.63, P < 0.001).
• Higher CTI levels correlated with greater coronary stenosis severity.
• CTI demonstrated better discriminative ability for CHD than other insulin resistance-related indices, with an AUC of 0.845.
• The final nomogram included smoking status, age, neutrophils, non-HDL-C, serum albumin, CTI, and SCAS.

Interpretation:

Higher CTI levels are associated with the presence of CHD and increased coronary lesion burden in patients with MASLD.

Limitations:

• The study's cross-sectional design limits causal inferences.
• Findings may not be generalizable to populations outside the study cohort.

Conclusion:

The developed nomogram may assist in identifying MASLD patients who require cardiovascular evaluation.