Inflammatory and Clinical Predictors of In-Hospital Mortality in Acute Coronary Syndrome: A Retrospective Cohort Study

Background: This study aims to retrospectively analyze in-hospital mortality rates in patients diagnosed with acute coronary syndrome (ACS) and to identify independent risk factors contributing to increased mortality. Materials and Methods: This Retrospective Single-Center Cohort Study was conducted at the Cardiolo-gy Clinic of Aktif International Hospital between January 1, 2023, and December 30, 2024. A total of 694 ACS patients were included in the study. Demographic, clinical, laboratory, and imaging data were collected. Independent risk factors for in-hospital mortality were assessed using multivariate logistic regression analysis. Results: The in-hospital mortality rate was 2.4%. Age (p = 0.02), the frequency of diabetes mellitus (p = 0.03) and hyperlipidemia (p = 0.04), creatinine (p = 0.002) and troponin-I (p < 0.001) were significant-ly higher, whereas left ventricular ejection fraction (LVEF) was significantly lower (p = 0.04) in non-survivors compared to the survivors. In addition, hematological parameters such as neutrophil-to-lymphocyte ratio (NLR) (p = 0.005) and platelet-to-lymphocyte ratio (PLR) (p = 0.01) were significantly elevated in non-survivors. Multivariate logistic regression analysis demonstrated that age (odds ration [OR] = 1.05, p = 0.003), presence of diabetes mellitus (OR=1.37, p = 0.002), hypertension (OR=1.42, p = 0.001) and hyperlipidemia (OR= 1.28, p = 0.03), increased troponin-I (OR = 2.34, p < 0.001), ele-vated creatinine levels (OR = 1.75, p = 0.002), lower LVEF (OR = 0.89, p = 0.04), NLR (OR = 1.56, p = 0.005) and PLR (OR = 1.42, p = 0.01) were independent predictors of in-hospital mortality. Conclusions: Our study suggests that older age, the presence of hypertension, diabetes mellitus, hy-perlipidemia, renal dysfunction, elevated inflammatory markers (NLR, PLR), and reduced LVEF are independent predictors of in-hospital mortality in ACS patients. Our findings further emphasize the critical role of early revascularization in reducing mortality rates in ACS patients.