Objective:

To evaluate the diagnostic and prognostic value of integrating Tei index, carotid IMT, and Crouse plaque score in assessing coronary artery calcification severity and predicting major adverse cardiovascular and cerebrovascular events in elderly patients with coronary heart disease.

Key Findings:

• Severe calcification group showed higher Tei index, IMT, and Crouse score compared to controls (all p < 0.001).
• Tei index, IMT, and Crouse score independently predicted severe CAC and correlated with the number of stenosed coronary vessels.
• Combined ROC analysis demonstrated superior diagnostic accuracy (AUC = 0.831) compared to individual biomarkers.
• High Tei index (≥0.50), IMT (≥0.86 mm), and Crouse score (≥1.21) predicted increased MACCE risk (log-rank p < 0.001).

Interpretation:

The integration of Tei index, carotid IMT, and Crouse score provides enhanced diagnostic precision for severe CAC and stratifies MACCE risk in elderly CHD patients.

Limitations:

• Retrospective design may introduce selection bias.
• Limited generalizability due to single-center study.
• Small sample size may affect statistical power.

Conclusion:

The combined use of Tei index, carotid IMT, and Crouse score offers a noninvasive strategy for improving CAC diagnosis and managing postoperative cardiovascular risk in elderly patients.