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...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1590658/full |
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| 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 |
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