Admission EASIX Score Predicts Coronary No-Reflow and In-Hospital Mortality in STEMI Patients Undergoing Primary PCI

Area of Science:

• Cardiology
• Biomarkers
• Clinical Risk Stratification

Background:

• Early risk stratification is crucial for ST-elevation myocardial infarction (STEMI) patients, particularly for predicting adverse outcomes like no-reflow phenomenon (NRP) and early mortality.
• The Endothelial Activation and Stress Index (EASIX), derived from routine labs, indicates systemic endothelial dysfunction and may serve as a prognostic tool.

Purpose of the Study:

• To evaluate the prognostic value of admission EASIX for predicting NRP and in-hospital mortality in STEMI patients undergoing primary percutaneous coronary intervention (pPCI).

Main Methods:

• Retrospective analysis of 1931 STEMI patients treated with pPCI.
• Calculation of admission EASIX and assessment of its association with NRP and in-hospital mortality.
• Utilized multivariable logistic regression, reclassification analyses (NRI/IDI), and ROC analysis for predictive performance evaluation.

Main Results:

• NRP occurred in 14.1% and in-hospital mortality in 2.5% of patients.
• Admission EASIX was independently associated with both NRP (adjusted OR 1.485) and in-hospital mortality (adjusted OR range 1.371-2.096).
• EASIX significantly improved risk reclassification for both outcomes, with ROC-AUCs of 0.706 for NRP and 0.810 for mortality.

Conclusions:

• Admission EASIX is a valuable, independent predictor of NRP and in-hospital mortality in STEMI patients.
• The EASIX score offers an accessible method to enhance early risk stratification in this patient population.
• External validation is recommended prior to widespread clinical implementation of EASIX.