Background: Early risk stratification in acute decompensated heart failure with reduced ejection fraction (ADHF-rEF) remains challenging. The Endothelial Activation and Stress Index (EASIX)—a composite of lactate dehydrogenase, creatinine, and platelet count—reflects endothelial dysfunction, a pathophysiological contributor to early deterioration in ADHF-rEF. This study evaluated the prognostic utility of admission-based EASIX for in-hospital mortality. Methods: In this retrospective single-center cohort, 850 consecutive patients hospitalized with ADHF-rEF between January 2022 and June 2025 were analyzed. EASIX was calculated from first-day laboratory values. Logistic regression, ROC analysis, restricted cubic splines, and Kaplan–Meier survival methods were used to assess the association between EASIX and in-hospital mortality, and to evaluate its incremental value beyond established clinical and laboratory predictors. Results: In-hospital mortality was 12.4%. Higher EASIX values were significantly associated with mortality in both univariable and multivariable models (adjusted OR 1.273; p < 0.001). EASIX demonstrated moderate discriminative performance among evaluated biomarkers (AUC 0.751) and showed a clear dose–response risk gradient, with mortality rising from 1.4% in the lowest tertile to 26.2% in the highest. Incorporating EASIX into clinical and laboratory prediction models yielded substantial continuous net reclassification improvement (0.59 and 0.38, respectively). Survival curves diverged early and remained distinctly separated across EASIX strata. Conclusions: Admission EASIX is an independent predictor of in-hospital mortality in ADHF-rEF and provides complementary prognostic information beyond conventional models. This is the first study to demonstrate the prognostic value of EASIX in the ADHF-rEF setting, supporting its potential utility as an accessible endothelial stress biomarker for early risk stratification.

Background and Objectives: In this study, we aimed to investigate the prognostic value of the C-reactive protein to albumin ratio (CAR) for all-cause mortality in patients with chronic heart failure with reduced ejection fraction (HFrEF). Materials and Methods: In total, 404 chronic HFrEF patients were included in this observational and retrospective study. The CAR value of each patient included in this analysis was calculated. We stratified the study population into tertiles (T1, T2, and T3) according to CAR values. The primary outcome of the analysis was to determine all-cause mortality. Results: The median follow-up period in our study was 30 months. In the follow-up, 162 (40%) patients died. The median value of CAR was higher in patients who did not survive during the follow-up [6.7 (IQR = 1.6–20.4) vs. 0.6 (IQR = 0.1–2.6), p < 0.001]. In addition, patients in the T3 tertile (patients with the highest CAR) had a higher rate of all-cause mortality [n = 90 cases (66.2%), p < 0.001]. Multivariate Cox regression analysis revealed that CAR was an independent predictor of mortality in patients with HFrEF (hazard ratio: 1.852, 95% confidence interval: 1.124–2.581, p = 0.005). In a receiver operating characteristic curve analysis, the optimal cut-off value of CAR was >2.78, with a sensitivity of 66.7% and specificity of 76%. Furthermore, older age, elevated N-terminal pro-brain natriuretic peptide levels, and absence of a cardiac device were also independently associated with all-cause death in HFrEF patients after 2.5 years of follow-up. Conclusions: The present study revealed that CAR independently predicts long-term mortality in chronic HFrEF patients. CAR may be used to predict mortality among these patients as a simple and easily obtainable inflammatory marker.

In this study, we aimed to evaluate the predictive value of admission C-reactive protein/albumin ratio (CAR) for acute kidney injury (AKI) in cases with moderate to severe chronic kidney disease (CKD) not on dialysis who presented with non-ST-segment elevation myocardial infarction (NSTEMI) and underwent coronary angiography (CAG). This cross-sectional and observational study included 420 NSTEMI patients. The study population was categorized based on the CAR tertiles as groups T1, T2, and T3. The primary outcome of the study was AKI development; 92 (21.9%) cases developed AKI. The frequency of AKI was significantly higher in the T3 group compared with the T2 and T1 groups (34% vs 17% vs 14%, P < .001). Age, estimated glomerular filtration rate, contrast media volume, and CAR (odds ratio: 1.36; 95% CI: 1.17-1.57; P < .01) were significant predictors of AKI. In a receiver operating characteristic curve analysis, CAR levels >0.20 predicted AKI development with a sensitivity of 74% and a specificity of 45%. We observed that the CAR may be a promising inflammatory parameter for AKI in NSTEMI patients with moderate to severe CKD after CAG.

Background: Early risk stratification in ST-elevation myocardial infarction (STEMI) remains critical, particularly for anticipating adverse outcomes such as the coronary no-reflow phenomenon (NRP) and early mortality. The Endothelial Activation and Stress Index (EASIX), calculated from routine laboratory parameters, has emerged as a potential biomarker reflecting systemic endothelial dysfunction. This study evaluated the prognostic value of admission EASIX for the NRP and in-hospital mortality in STEMI patients undergoing primary percutaneous coronary intervention (pPCI). Methods: In this retrospective single-center cohort, 1931 STEMI patients treated with pPCI between January 2023 and January 2025 were included. EASIX was calculated at admission. NRP was defined as post-PCI TIMI flow ≤ 2 or TIMI 3 flow with impaired myocardial blush (TMPG ≤ 1). Multivariable logistic regression, reclassification analyses (NRI/IDI), ROC analysis, and calibration methods were used to assess predictive performance. Sensitivity and interaction analyses were conducted. Results: NRP occurred in 14.1%, and in-hospital mortality was 2.5%. EASIX was independently associated with both outcomes (NRP: adjusted OR 1.485, 95% CI 1.286–1.715; mortality: adjusted OR range 1.371–2.096 across models; all p < 0.001). EASIX significantly improved risk reclassification for both NRP and in-hospital mortality (NRI > 0.20). ROC-AUCs were 0.706 for NRP and 0.810 for mortality. Restricted cubic spline and LOWESS analyses revealed nonlinear risk escalation. Calibration plots and Brier scores confirmed model reliability. Associations persisted across ischemic time and renal function strata. Conclusions: Admission EASIX is independently associated with NRP and in-hospital mortality in STEMI. Easily accessible and integrative, EASIX may enhance early risk stratification. External validation is warranted before clinical implementation.

The Osaka Prognostic Score (OPS) is a composite index reflecting systemic inflammation and nutritional status, derived from C-reactive protein, albumin, and lymphocyte count. This retrospective study evaluated the association between OPS and all-cause in-hospital mortality in 959 patients with non-ST-elevation myocardial infarction (NSTEMI) undergoing early percutaneous coronary intervention from September 2022 to November 2024. Patients were stratified into 4 groups based on OPS (0-3), with all-cause in-hospital mortality as the primary endpoint. Cox proportional hazards modeling was used to identify independent predictors of mortality, and receiver operating characteristic analysis assessed the prognostic performance of OPS. During hospitalization (maximum 12 days), 106 patients (11.0%) died. Non-survivors were significantly older (69.1 vs 58.9 years, P < .001) and more frequently female (36.8 vs 19%, P < .001). Independent predictors included advanced age, low diastolic blood pressure, higher Killip class, reduced left ventricular ejection fraction, elevated creatinine and troponin levels, and high OPS values (hazard ratio: 3.032; 95% confidence interval [CI]: 2.003-4.102; P < .001). An OPS threshold of 1.5 yielded 94% sensitivity and 74% specificity (95% CI: 0.859-0.937; P < .001), with mortality rates of 3.7%, 4.2%, 17.1%, and 59.1% across OPS categories ( P < .001). Incorporating OPS with conventional risk factors may enhance the risk stratification of NSTEMI.

Newly diagnosed AF (NOAF) associated with acute STEMI holds significant relevance in clinical practice. This study seeks to assess the role of the monocyte to HDL-C ratio (MHR) in predicting NOAF in these patients. Between July 2017 and May 2018, 663 patients who underwent primary PCI for STEMI were retrospectively analyzed. NOAF was identified in 34 patients (5.1%), and this group was compared with those without AF. The NOAF group experienced a longer hospitalization duration and a higher mortality rate (11.8 vs. 4.3%, p = 0.044) compared to the non-AF group. In a multivariable analysis, increased MHR (OR: 1.413, 95% CI: 1.203-1.657, p = 0.005), advanced age, decreased LVEF, Killip class 2-4, diabetes mellitus, hypertension, and left atrial enlargement emerged as independent predictors for the development of NOAF in STEMI. ROC curve analysis revealed that MHR values exceeding 26.54 strongly predict NOAF, achieving sensitivity and specificity above 70% (AUC: 0.768, 95%CI: 0.734-0.801, p < 0.001). The present study revealed that increased MHR robust indicator for NOAF in STEMI patients and can be easily assessed in clinical practice. Incorporating MHR alongside established traditional risk factors may enhance the identification of patients at risk for AF in those with STEMI.