Association between endothelial activation and stress index and 30-day mortality risk in acute myocardial infarction patients: a study based on the medical information mart for intensive care-IV database

BMC Cardiovasc Disord. 2024 Dec 4;24(1):699. doi: 10.1186/s12872-024-04353-5.

Abstract

Objective: This study aimed to evaluate the association between the Endothelial Activation and Stress Index (EASIX) and 30-day mortality risk in acute myocardial infarction (AMI) patients.

Methods: Using a retrospective cohort design, data were extracted from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database between 2008 and 2019. Patients diagnosed with AMI at intensive care unit (ICU) admission were included. EASIX score was calculated as follows: lactate dehydrogenase (LDH) level (U/L) × creatinine level (mg/dL)/platelet count (109/L). Cox regression models assessed the association between EASIX and 30-day mortality, with subgroup analyses based on age, gender, AMI subtype, and sepsis status.

Results: A total of 1,036 patients were analyzed, among whom 323 did not survive beyond 30 days post-ICU admission. Higher EASIX scores were associated with increased 30-day mortality in AMI patients [Hazard ratio (HR): 1.70, 95% confidence interval (CI): 1.17-2.46, P = 0.005). Subgroup analyses supported these findings and revealed significant interactions between EASIX and variables such as gender and AMI subtype (P < 0.05).

Conclusion: Elevated EASIX scores are significantly correlated with increased 30-day mortality risk in AMI patients, suggesting EASIX as a valuable prognostic tool that may inform clinical management strategies to improve outcomes in AMI.

Clinical trial number: Not applicable.

Keywords: Acute myocardial infarction; Association; Endothelial activation and stress index; Mortality.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers* / blood
  • Creatinine / blood
  • Databases, Factual*
  • Endothelium, Vascular / physiopathology
  • Female
  • Humans
  • Intensive Care Units
  • L-Lactate Dehydrogenase / blood
  • Male
  • Middle Aged
  • Myocardial Infarction* / diagnosis
  • Myocardial Infarction* / mortality
  • Myocardial Infarction* / physiopathology
  • Platelet Count
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors

Substances

  • Biomarkers
  • Creatinine
  • L-Lactate Dehydrogenase