Key result
Higher inflammatory burden index is linked to ~19% lower odds of MINOCA versus MICAD.
Cohort (n=772)
Yes
Patients presenting with MINOCA have a significantly lower systemic inflammatory burden at admission—as measured by the inflammatory burden index (IBI)—compared to patients with obstructive myocardial infarction (MICAD), even after adjusting for infarct severity and clinical covariates.
Background Myocardial infarction with non-obstructive coronary arteries (MINOCA) represents a heterogeneous clinical syndrome. The association between systemic inflammatory burden and MINOCA remains unclear. We evaluated this association using the admission inflammatory burden index (IBI). Methods This multicenter retrospective observational study screened 5,746 patients with acute myocardial infarction undergoing coronary angiography. The final cohort included 247 patients with MINOCA after clinical, angiographic, and cardiac magnetic resonance evaluation and a computer-generated random sample of 525 patients with myocardial infarction with obstructive coronary artery disease (MICAD). IBI was calculated as high-sensitivity C-reactive protein multiplied by the neutrophil-to-lymphocyte ratio. Multivariable logistic regression and restricted cubic spline analyses evaluated the association between IBI and the MINOCA phenotype. Quartile, subgroup, and sensitivity analyses assessed robustness of the findings. Results IBI levels were lower in patients with MINOCA than in those with MICAD (P < 0.001). Lower IBI was associated with the MINOCA phenotype in both unadjusted (OR 0.599, 95% CI 0.527–0.678, P < 0.001) and multivariable-adjusted analyses (OR 0.813, 95% CI 0.697–0.949, P = 0.009). Restricted cubic spline analysis demonstrated a nonlinear association (P for overall < 0.001; P for nonlinearity < 0.001), while quartile analysis showed attenuation in the highest quartile (P for trend = 0.047). The findings were generally consistent across predefined subgroup and sensitivity analyses. Conclusions Lower admission IBI was associated with the MINOCA phenotype. These findings indicate differences in admission inflammatory burden between myocardial infarction phenotypes and should be considered hypothesis-generating. Trial registration Not applicable. Clinical trial number Not applicable.
No takes yet. Share an insight, caveat, or question.
Chijie et al. (2026) conducted a cohort in Acute myocardial infarction (MINOCA vs MICAD) (n=772). Admission inflammatory burden index (IBI, calculated as hs-CRP × neutrophil-to-lymphocyte ratio; modeled as ln(IBI+1)) vs. Lower admission IBI levels / lowest quartile (Q1) of ln(IBI+1); MICAD as reference outcome phenotype was evaluated on Myocardial infarction with non-obstructive coronary arteries (MINOCA) phenotype versus myocardial infarction with obstructive coronary artery disease (MICAD) (OR 0.813, 95% CI 0.697–0.949, p=0.009). Admission inflammatory burden index (IBI) was significantly lower in MINOCA than MICAD (median 10.60 vs 32.40) and independently associated with the MINOCA phenotype (adjusted OR 0.813, P=0.009).
Synapse has enriched 5 related papers. Consider them for comparative context:
More from BMC Cardiovascular Disorders