Association of systemic inflammation with major adverse cardiovascular events in patients with acute myocardial infarction.

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.