Yang Zhenkun, Li Yuanjie, Guo Taipu, Yang Mingjuan, Chen Yang, Gao Yuxia
Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, People's Republic of China.
Department of Anesthesiology, Tianjin Research Institute of Anesthesiology, Tianjin Medical University General Hospital, Tianjin, China.
Sci Rep. 2025 Apr 25;15(1):14514. doi: 10.1038/s41598-025-98408-y.
Consider that inflammatory factors are associated with short-term mortality in patients with acute myocardial infarction (AMI). In this retrospective analysis of 2,784 AMI patients from the Medical Information Mart for Intensive Care-IV database, we evaluated the impact of inflammatory markers on in-hospital mortality and predicted 30-day and 90-day outcomes. Patients were divided into groups based on in-hospital survival (n = 2,364) and mortality (n = 420). Analysis of initial hospital admission laboratory data, including inflammatory factors, revealed these factors as independent predictors of in-hospital mortality (Q4 of RDW: OR 1.96, NLR: OR 1.63, SII: OR 1.85, and SIRI: OR 2.23, all P < 0.05). Cox proportional hazards models confirmed their significance for predicting 30-day (Q4 of NLR: OR 1.83, SII: OR 1.86, and SIRI: OR 2.01, all P < 0.05) and 90-day mortality (Q4 of RDW: OR 1.46, NLR: OR 1.69, SII: OR 1.73, and SIRI: OR 1.72, all P < 0.05). Increasing levels of inflammatory markers correlated with higher odds and hazard ratios, as illustrated by Restricted Cubic Spline curves. Kaplan-Meier survival analysis showed better survival rates with lower inflammatory marker levels. Receiver operating characteristic curves demonstrated good predictive performance of individual inflammatory factors, with a new composite marker showing the highest predictive ability (AUC = 0.720). This study underscores the association of inflammatory factors with both hospital and short-term mortality in AMI patients.
考虑到炎症因子与急性心肌梗死（AMI）患者的短期死亡率相关。在这项对重症监护医学信息数据库-IV中2784例AMI患者的回顾性分析中，我们评估了炎症标志物对住院死亡率的影响，并预测了30天和90天的预后。根据住院期间的生存情况（n = 2364）和死亡率（n = 420）将患者分组。对包括炎症因子在内的初始入院实验室数据进行分析，发现这些因子是住院死亡率的独立预测因素（红细胞分布宽度四分位数4：OR 1.96，中性粒细胞与淋巴细胞比值：OR 1.63，全身炎症反应指数：OR 1.85，全身免疫炎症指数：OR 2.23，均P < 0.05）。Cox比例风险模型证实了它们对预测30天死亡率（中性粒细胞与淋巴细胞比值四分位数4：OR 1.83，全身炎症反应指数：OR 1.86，全身免疫炎症指数：OR 2.01，均P < 0.05）和90天死亡率（红细胞分布宽度四分位数4：OR 1.46，中性粒细胞与淋巴细胞比值：OR 1.69，全身炎症反应指数：OR 1.73，全身免疫炎症指数：OR 1.72，均P < 0.05）的意义。如限制立方样条曲线所示，炎症标志物水平升高与更高的比值比和风险比相关。Kaplan-Meier生存分析显示，炎症标志物水平较低时生存率更高。受试者工作特征曲线显示个体炎症因子具有良好的预测性能，一种新的复合标志物显示出最高的预测能力（AUC = 0.720）。本研究强调了炎症因子与AMI患者的住院和短期死亡率之间的关联。
