The association between multi-inflammatory index and long-term mortality in post-myocardial infarction patients treated with percutaneous coronary intervention

BackgroundInflammation plays a crucial role in the pathophysiology of acute myocardial infarction (AMI), and various inflammatory markers have been associated with patient outcomes. The multi-inflammatory index (MII) has emerged as a potential prognostic indicator, but its relationship with AMI mort...

Full description

Saved in:
Bibliographic Details
Main Authors: Sangho Hyun, Jaeho Seung, Kwan Yong Lee, Sang Hyun Kim, Myunhee Lee, Andrew H. Yoon, Wonjae Lee, Byung-Hee Hwang, Eun-Ho Choo, Chan Jun Kim, Jin-Jin Kim, Ha-Wook Park, Gyu Chul Oh, Yun Seok Choi, Youngkeun Ahn, Kiyuk Chang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Cardiovascular Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1590658/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849434858251616256
author Sangho Hyun
Jaeho Seung
Kwan Yong Lee
Kwan Yong Lee
Sang Hyun Kim
Myunhee Lee
Andrew H. Yoon
Wonjae Lee
Byung-Hee Hwang
Eun-Ho Choo
Chan Jun Kim
Jin-Jin Kim
Ha-Wook Park
Gyu Chul Oh
Yun Seok Choi
Youngkeun Ahn
Kiyuk Chang
author_facet Sangho Hyun
Jaeho Seung
Kwan Yong Lee
Kwan Yong Lee
Sang Hyun Kim
Myunhee Lee
Andrew H. Yoon
Wonjae Lee
Byung-Hee Hwang
Eun-Ho Choo
Chan Jun Kim
Jin-Jin Kim
Ha-Wook Park
Gyu Chul Oh
Yun Seok Choi
Youngkeun Ahn
Kiyuk Chang
author_sort Sangho Hyun
collection DOAJ
description BackgroundInflammation plays a crucial role in the pathophysiology of acute myocardial infarction (AMI), and various inflammatory markers have been associated with patient outcomes. The multi-inflammatory index (MII) has emerged as a potential prognostic indicator, but its relationship with AMI mortality remains unclear.MethodsWe analyzed 8,414 patients with successfully revascularized AMI. The subjects were divided into a high MII group (n = 3,708) or a low MII group (n = 4,706) using the MII score at admission. The MII score was calculated using the initial serum neutrophil, lymphocyte, and C-reactive protein (CRP). The primary and secondary outcomes were all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE).ResultsOver a median follow-up of 5.13 years, the high MII group showed significantly higher incidences of all-cause mortality and MACCE than the low MII group (p < 0.001, each). Multivariate Cox regression identified a high MII score as an independent predictor of all-cause mortality and MACCE [adjusted hazard ratio (HR) 1.71; 95% confidence interval (CI) 1.55–1.89; p < 0.001, HR 1.53; 95% CI 1.40–1.67; p < 0.001]. MII score had statistically higher discriminative ability for predicting all-cause mortality than the conventional inflammatory marker, CRP (C-index 0.662; 95% CI 0.648–0.677 vs. 0.646; 95% CI 0.632–0.661, p < 0.001). The predictive accuracies of traditional clinical factor discrimination and reclassification for mortality were significantly improved upon the addition of high MII score (C-index 0.791 vs. 0.780; 95% CI 0.780–0.803; p < 0.001, NRI 0.018; 95% CI 0.014–0.021; p < 0.001).ConclusionIn the AMI cohort, a high MII score was strongly associated with long-term mortality and MACCE.
format Article
id doaj-art-dcd22f22dda44f35b6d2893fbea92ce2
institution Kabale University
issn 2297-055X
language English
publishDate 2025-06-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Cardiovascular Medicine
spelling doaj-art-dcd22f22dda44f35b6d2893fbea92ce22025-08-20T03:26:30ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-06-011210.3389/fcvm.2025.15906581590658The association between multi-inflammatory index and long-term mortality in post-myocardial infarction patients treated with percutaneous coronary interventionSangho Hyun0Jaeho Seung1Kwan Yong Lee2Kwan Yong Lee3Sang Hyun Kim4Myunhee Lee5Andrew H. Yoon6Wonjae Lee7Byung-Hee Hwang8Eun-Ho Choo9Chan Jun Kim10Jin-Jin Kim11Ha-Wook Park12Gyu Chul Oh13Yun Seok Choi14Youngkeun Ahn15Kiyuk Chang16College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaCardiovascular Center and Cardiology Division, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaCardiovascular Center and Cardiology Division, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaCardiovascular Research Institute for Intractable Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaCardiovascular Center and Cardiology Division, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaSchool of Public Health, San Diego State University, San Diego, CA, United StatesCarle Illinois College of Medicine, University of Illinois at Urbana-Campaign, Urbana, IL, United StatesDepartment of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaCardiovascular Center and Cardiology Division, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaCardiovascular Center and Cardiology Division, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaCardiovascular Center and Cardiology Division, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, Uijeongbu, Republic of KoreaCardiovascular Center and Cardiology Division, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Cardiology, Bucheon Sejong Hospital, Bucheon, Republic of KoreaCardiovascular Center and Cardiology Division, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaCardiovascular Center and Cardiology Division, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Republic of KoreaCardiovascular Center and Cardiology Division, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaBackgroundInflammation plays a crucial role in the pathophysiology of acute myocardial infarction (AMI), and various inflammatory markers have been associated with patient outcomes. The multi-inflammatory index (MII) has emerged as a potential prognostic indicator, but its relationship with AMI mortality remains unclear.MethodsWe analyzed 8,414 patients with successfully revascularized AMI. The subjects were divided into a high MII group (n = 3,708) or a low MII group (n = 4,706) using the MII score at admission. The MII score was calculated using the initial serum neutrophil, lymphocyte, and C-reactive protein (CRP). The primary and secondary outcomes were all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE).ResultsOver a median follow-up of 5.13 years, the high MII group showed significantly higher incidences of all-cause mortality and MACCE than the low MII group (p < 0.001, each). Multivariate Cox regression identified a high MII score as an independent predictor of all-cause mortality and MACCE [adjusted hazard ratio (HR) 1.71; 95% confidence interval (CI) 1.55–1.89; p < 0.001, HR 1.53; 95% CI 1.40–1.67; p < 0.001]. MII score had statistically higher discriminative ability for predicting all-cause mortality than the conventional inflammatory marker, CRP (C-index 0.662; 95% CI 0.648–0.677 vs. 0.646; 95% CI 0.632–0.661, p < 0.001). The predictive accuracies of traditional clinical factor discrimination and reclassification for mortality were significantly improved upon the addition of high MII score (C-index 0.791 vs. 0.780; 95% CI 0.780–0.803; p < 0.001, NRI 0.018; 95% CI 0.014–0.021; p < 0.001).ConclusionIn the AMI cohort, a high MII score was strongly associated with long-term mortality and MACCE.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1590658/fullinflammatory markermyocardial infarctionbiomarkerprognosisC-reactive protein
spellingShingle Sangho Hyun
Jaeho Seung
Kwan Yong Lee
Kwan Yong Lee
Sang Hyun Kim
Myunhee Lee
Andrew H. Yoon
Wonjae Lee
Byung-Hee Hwang
Eun-Ho Choo
Chan Jun Kim
Jin-Jin Kim
Ha-Wook Park
Gyu Chul Oh
Yun Seok Choi
Youngkeun Ahn
Kiyuk Chang
The association between multi-inflammatory index and long-term mortality in post-myocardial infarction patients treated with percutaneous coronary intervention
Frontiers in Cardiovascular Medicine
inflammatory marker
myocardial infarction
biomarker
prognosis
C-reactive protein
title The association between multi-inflammatory index and long-term mortality in post-myocardial infarction patients treated with percutaneous coronary intervention
title_full The association between multi-inflammatory index and long-term mortality in post-myocardial infarction patients treated with percutaneous coronary intervention
title_fullStr The association between multi-inflammatory index and long-term mortality in post-myocardial infarction patients treated with percutaneous coronary intervention
title_full_unstemmed The association between multi-inflammatory index and long-term mortality in post-myocardial infarction patients treated with percutaneous coronary intervention
title_short The association between multi-inflammatory index and long-term mortality in post-myocardial infarction patients treated with percutaneous coronary intervention
title_sort association between multi inflammatory index and long term mortality in post myocardial infarction patients treated with percutaneous coronary intervention
topic inflammatory marker
myocardial infarction
biomarker
prognosis
C-reactive protein
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1590658/full
work_keys_str_mv AT sanghohyun theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT jaehoseung theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT kwanyonglee theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT kwanyonglee theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT sanghyunkim theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT myunheelee theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT andrewhyoon theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT wonjaelee theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT byungheehwang theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT eunhochoo theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT chanjunkim theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT jinjinkim theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT hawookpark theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT gyuchuloh theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT yunseokchoi theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT youngkeunahn theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT kiyukchang theassociationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT sanghohyun associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT jaehoseung associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT kwanyonglee associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT kwanyonglee associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT sanghyunkim associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT myunheelee associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT andrewhyoon associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT wonjaelee associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT byungheehwang associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT eunhochoo associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT chanjunkim associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT jinjinkim associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT hawookpark associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT gyuchuloh associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT yunseokchoi associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT youngkeunahn associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention
AT kiyukchang associationbetweenmultiinflammatoryindexandlongtermmortalityinpostmyocardialinfarctionpatientstreatedwithpercutaneouscoronaryintervention