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

Abstract

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

• Association
• Endothelial activation and stress index
• Mortality
• Acute myocardial infarction