Key result
Higher Inflammatory Burden Index linked to ~83% higher risk of 1-year MACE.
Why the study?
Inflammatory activation may contribute to adverse remodeling and recurrent cardiovascular events after myocardial infarction, but its prognostic value in patients with HFpEF remains uncertain.
Does a higher admission Inflammatory Burden Index (IBI) predict an increased risk of 1-year major adverse cardiovascular events in patients with HFpEF after myocardial infarction?
Cohort (n=592)
No
Does a higher admission Inflammatory Burden Index (IBI) predict an increased risk of 1-year major adverse cardiovascular events in patients with HFpEF after myocardial infarction?
Hazard Ratio: 1.828 (95% CI 1.529–2.186)
p-value: p=< 0.001
May support IBI for MACE risk stratification in post-MI HFpEF; leaves open whether targeting inflammation improves outcomes.
Background Inflammatory activation may contribute to adverse remodeling and recurrent cardiovascular events after myocardial infarction (MI), but its prognostic value in patients with heart failure with preserved ejection fraction (HFpEF) remains uncertain. This study evaluated whether the Inflammatory Burden Index (IBI) was associated with 1-year major adverse cardiovascular events (MACE) in patients with HFpEF and documented MI. Method In this single-centre retrospective cohort study, 625 patients hospitalized at Fuyang People's Hospital from January 2018 to December 2023 were screened. After 33 patients with incomplete follow-up or unavailable baseline data were excluded, 592 patients were included. IBI was calculated as C-reactive protein multiplied by the neutrophil-to-lymphocyte ratio. The Youden-derived IBI cutoff of 7.70 was used only for descriptive grouping and sensitivity analysis. The primary Cox model treated log-transformed IBI (logIBI) as a continuous predictor and adjusted for age, sex, hypertension, diabetes mellitus, LDL-C and soluble ST2. Discrimination, calibration and clinical usefulness were assessed using the C-index, 365-day AUC, Brier score, calibration slope, Hosmer-Lemeshow test and decision curve analysis. Results During 1-year follow-up, 74 patients experienced MACE (12.5%). Higher logIBI was independently associated with 1-year MACE (HR 1.828, 95% CI 1.529–2.186, P < 0.001). In the sensitivity model, high IBI was also associated with increased MACE risk (HR 4.126, 95% CI 2.512–6.776, P < 0.001). Adding logIBI improved the 365-day AUC from 0.790 to 0.832 and increased the C-index from 0.776 to 0.817. The expanded model showed generally acceptable calibration, with a Brier score of 0.075, calibration slope of 0.938 and Hosmer-Lemeshow P value of 0.202. Decision curve analysis suggested higher net benefit after adding logIBI. Conclusion In patients with HFpEF and documented MI, higher logIBI was independently associated with 1-year MACE and improved risk discrimination when added to a base clinical model. IBI may provide a practical admission-level measure of residual inflammatory burden, but external validation and prospective assessment are needed before clinical use.
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Yin et al. (2026) conducted a cohort in Heart failure with preserved ejection fraction (HFpEF) after myocardial infarction (n=592). Inflammatory Burden Index (IBI) / logIBI vs. Lower Inflammatory Burden Index was evaluated on 1-year major adverse cardiovascular events (MACE), defined as the first occurrence of cardiac death, non-fatal recurrent MI, or readmission for heart failure (HR 1.828, 95% CI 1.529-2.186, p=< 0.001). Higher log-transformed Inflammatory Burden Index was independently associated with an increased risk of 1-year major adverse cardiovascular events (HR 1.828).
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