American journal of preventive cardiology · 2026
Association of systemic inflammation with major adverse cardiovascular events in patients with acute myocardial infarction.
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Nguyen Chi, Ackermann Amanda M, Marieb Erica, Skaar Jeffrey R, Chow Wing, Ryali Radha, Popadic Lyuba, Wu Xiyuan, Ma Xinshuo, E Kearney Kathleen
Аннотация
OBJECTIVE: Assess the association of systemic inflammation (SI) with major adverse cardiovascular events (MACE) and heart failure (HF) in patients with acute myocardial infarction (AMI).
METHODS: This retrospective cohort study included adults hospitalized for type 1 AMI from July 2016 through December 2023 in the Komodo Healthcare Map database. High-sensitivity C-reactive protein (hsCRP) test results 1 year before or after admission determined SI status (with SI, ≥1 test 2-10 mg/L; without SI, all tests <2 mg/L). hsCRP tests within 30 days post-AMI or hospitalization, associated with antimicrobial or corticosteroid use, or with values >10 mg/L were excluded. Incidence of revised 3-point MACE (nonfatal MI, nonfatal stroke, or all-cause mortality), revised 4-point MACE (nonfatal MI, nonfatal stroke, urgent revascularization, or all-cause mortality), and HF were estimated per 1000 person-years (PY). Cox regression models assessed the adjusted association between SI and the outcomes.
RESULTS: Among 3149 eligible patients (mean age, 61 years), 46.4% had SI. Compared with patients without SI, patients with SI were more likely to be female and have more comorbidities. Patients with SI had a higher incidence of revised 3-point (45.4 vs. 27.3/1,000PY) and 4-point MACE (52.1 vs. 35.1/1,000PY). SI was associated with increased risk of revised 3-point and 4-point MACE (HR=1.39 [95% CI, 1.08-1.78] and 1.26 [1.01-1.58], respectively). Among patients without prior HF (n = 1988), SI was associated with increased risk of HF hospitalization (HR=2.04 [1.26-3.30]).
CONCLUSIONS: Patients with AMI and SI have an increased risk of MACE and incident HF hospitalization compared with patients with AMI without SI.
METHODS: This retrospective cohort study included adults hospitalized for type 1 AMI from July 2016 through December 2023 in the Komodo Healthcare Map database. High-sensitivity C-reactive protein (hsCRP) test results 1 year before or after admission determined SI status (with SI, ≥1 test 2-10 mg/L; without SI, all tests <2 mg/L). hsCRP tests within 30 days post-AMI or hospitalization, associated with antimicrobial or corticosteroid use, or with values >10 mg/L were excluded. Incidence of revised 3-point MACE (nonfatal MI, nonfatal stroke, or all-cause mortality), revised 4-point MACE (nonfatal MI, nonfatal stroke, urgent revascularization, or all-cause mortality), and HF were estimated per 1000 person-years (PY). Cox regression models assessed the adjusted association between SI and the outcomes.
RESULTS: Among 3149 eligible patients (mean age, 61 years), 46.4% had SI. Compared with patients without SI, patients with SI were more likely to be female and have more comorbidities. Patients with SI had a higher incidence of revised 3-point (45.4 vs. 27.3/1,000PY) and 4-point MACE (52.1 vs. 35.1/1,000PY). SI was associated with increased risk of revised 3-point and 4-point MACE (HR=1.39 [95% CI, 1.08-1.78] and 1.26 [1.01-1.58], respectively). Among patients without prior HF (n = 1988), SI was associated with increased risk of HF hospitalization (HR=2.04 [1.26-3.30]).
CONCLUSIONS: Patients with AMI and SI have an increased risk of MACE and incident HF hospitalization compared with patients with AMI without SI.