The effect of inflammatory markers on mortality in patients with acute myocardial infarction

Abstract

Abstract Consider that inflammatory factors are associated with short-term mortality in patients with acute myocardial infarction (AMI). In this retrospective analysis of 2,784 AMI patients from the Medical Information Mart for Intensive Care-IV database, we evaluated the impact of inflammatory markers on in-hospital mortality and predicted 30-day and 90-day outcomes. Patients were divided into groups based on in-hospital survival (n = 2,364) and mortality (n = 420). Analysis of initial hospital admission laboratory data, including inflammatory factors, revealed these factors as independent predictors of in-hospital mortality (Q4 of RDW: OR 1.96, NLR: OR 1.63, SII: OR 1.85, and SIRI: OR 2.23, all P < 0.05). Cox proportional hazards models confirmed their significance for predicting 30-day (Q4 of NLR: OR 1.83, SII: OR 1.86, and SIRI: OR 2.01, all P < 0.05) and 90-day mortality (Q4 of RDW: OR 1.46, NLR: OR 1.69, SII: OR 1.73, and SIRI: OR 1.72, all P < 0.05). Increasing levels of inflammatory markers correlated with higher odds and hazard ratios, as illustrated by Restricted Cubic Spline curves. Kaplan-Meier survival analysis showed better survival rates with lower inflammatory marker levels. Receiver operating characteristic curves demonstrated good predictive performance of individual inflammatory factors, with a new composite marker showing the highest predictive ability (AUC = 0.720). This study underscores the association of inflammatory factors with both hospital and short-term mortality in AMI patients.