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EASIX (endothelial activation and stress index) predicts mortality in patients with coronary artery disease

Daniel Finke1,2, Hauke Hund1, Norbert Frey1,2

  • 1Department of Cardiology, Medizinische Klinik III, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|September 10, 2024
PubMed

Insights

The Endothelial Activation and Stress Index (EASIX) effectively predicts mortality risk in coronary artery disease (CAD) patients. This validated biomarker offers crucial insights into patient survival, regardless of measurement timing relative to catheterization.

Area of Science:

  • Cardiology
  • Biomarker Research
  • Vascular Biology

Background:

  • Coronary interventions improve outcomes in acute coronary syndrome.
  • Systemic endothelial health significantly impacts mortality risk in coronary artery disease (CAD).
  • The Endothelial Activation and Stress Index (EASIX) is a known predictor of endothelial complications and survival.

Purpose of the Study:

  • To investigate the hypothesis that EASIX can predict mortality in patients diagnosed with CAD.
  • To validate EASIX as a prognostic biomarker for CAD patients.

Main Methods:

  • EASIX was measured in 1283 patients before coronary catheterization (CC) and correlated with survival.
  • An independent cohort of 1934 patients was used to validate EASIX measurements taken after CC (EASIXval).
  • Multivariable Cox regression and Brier score analyses were employed to assess predictive accuracy.

Main Results:

  • EASIX significantly predicted mortality risk post-CC, even after adjusting for clinical factors (HR 1.29).
  • EASIX measurements before and after CC (EASIXval) showed strong correlation (rho=0.7).
  • EASIXval demonstrated long-term predictive value (HR 1.53), with pre-established cut-offs indicating significantly increased mortality risk.

Conclusions:

  • The study validated EASIX as a reliable biomarker for predicting mortality in CAD patients.
  • EASIX demonstrates prognostic utility irrespective of its measurement timing relative to cardiac catheterization.
  • EASIX offers a valuable tool for risk stratification in patients with coronary artery disease.
Abstract

Keywords:
Allogeneic stem cell transplantationCoronary artery diseaseCreatinineEASIXEndothelial activation and stress indexEndothelial dysfunctionHeart failureHs-cTnTLDHLVEFLactate dehydrogenaseLeft ventricular ejection fractionMortality predictionNT-proBNPPlateletsTA-TMAThrombocytesTransplant-associated thrombotic microangiopathy

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