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December 7, 2025BMC Cardiovascular DisordersOpen Access

Association between the aggregate index of systemic inflammation and 28- or 365-day mortality in acute myocardial infarction patients: insights from the MIMIC-IV database

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Authors

KYKangzheng YuanFLFangmei LiuJWJian Wang

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Overview

Retrospective study reveals elevated systemic inflammation index increases short- and long-term mortality in acute myocardial infarction patients, highlighting heightened risk in women.

Key Points

  • To assess the relationship between the aggregate index of systemic inflammation and 28-day and 365-day mortality in patients with acute myocardial infarction.
  • Retrospective study analyzing 969 acute myocardial infarction patients from the MIMIC-IV database.
  • Patients were stratified into tertiles according to their aggregate index of systemic inflammation, calculated from neutrophil, monocyte, platelet, and lymphocyte counts.
  • Cox proportional hazards regression, Kaplan-Meier analyses, restricted cubic splines, and receiver operating characteristic curves evaluated mortality risk and predictive accuracy.
  • The highest inflammation tertile had significantly higher 28-day mortality (18.6% vs. 5.6% in low/medium groups, P < 0.001) and 365-day mortality (27.2% vs. 13.3% in the low group, P < 0.001).
  • Restricted cubic spline modeling showed a nonlinear association with mortality at 28 days (likelihood ratio test P = 0.001) and 365 days (P = 0.002), with multivariable Cox regression confirming a dose-response trend (P < 0.001).
  • Female patients displayed greater sensitivity to elevated inflammation, yielding higher predictive accuracy at 28 days (AUC: 0.759 vs. 0.669, P = 0.019; interaction P = 0.041) and 365 days (AUC: 0.760 vs. 0.730, P = 0.038; interaction P = 0.011).

Cite This Study

Yuan et al. (2025) studied this question.

synapsesocial.com/papers/6a8803c4bc5f9fd513bbf009https://doi.org/10.1186/s12872-025-05401-4
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