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: 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 no-reflow (NR) phenomenon is a serious complication of primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI), often reflecting distal embolization and microvascular obstruction, and representing a substrate for periprocedural (type 4a) myocardial infarction. NR has been linked to worse prognosis, including higher short- and long-term mortality. Inflammation is a key contributor to NR development. This study aimed to evaluate the relationship between the derived neutrophil-to-lymphocyte ratio (dNLR) and NR in STEMI patients undergoing PCI, and to assess its predictive value. This retrospective, single-center observational study included consecutive STEMI patients undergoing primary PCI between May 2024 and May 2025. Patients were grouped based on post-procedural TIMI flow grade. Demographic, clinical, and laboratory parameters were compared. Regression and ROC analyses were performed. A total of 208 patients were analyzed, among whom no-reflow occurred in 26.4% (n = 55). The NR group had significantly higher dNLR, C-reactive protein (CRP), glucose, creatinine, and troponin levels, along with lower left ventricular ejection fraction (LVEF). dNLR, diabetes mellitus, CRP and LVEF were independent predictors of NR. dNLR is a simple, cost-effective marker that may help identify patients at high risk of no-reflow in STEMI. Further prospective studies are warranted.

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.

Objective: Peripheral artery disease (PAD) is a chronic circulatory disorder characterized by atherosclerotic plaque buildup in the peripheral vascular system, restricting blood flow to the lower extremities and carrying a significant risk of morbidity and mortality. This study investigates the role of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score as a prognostic marker for assessing the severity of lower extremity peripheral artery disease (LEAD). The HALP score integrates hematologic and nutritional markers, providing a composite index that may reflect both the inflammatory and nutritional states impacting LEAD progression. Methods: A cross-sectional retrospective study was conducted, analyzing 186 patients diagnosed with LEAD through peripheral angiography. Participants were classified according to the TransAtlantic Inter-Society Consensus (TASC) II criteria, with mild to moderate disease (TASC A-B) and severe disease (TASC C-D). Laboratory data were collected within the first week of diagnosis, and HALP scores were calculated. The association between HALP scores and LEAD severity was evaluated through correlation and logistic regression analyses. Inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were also analyzed. Results: Significant differences were observed between TASC A-B and TASC C-D groups in demographic and clinical variables. Patients in the severe LEAD group were older, had a higher prevalence of diabetes and hyperlipidemia, and exhibited lower hemoglobin and albumin levels with higher platelet counts ( p < .001). A significant inverse correlation was found between HALP score and LEAD severity (R = −0.607, p < .001), indicating that lower HALP scores are associated with more advanced disease. The HALP score displayed strong discriminatory performance in ROC analysis (AUC = 0.889), with an optimal cut-off of 3.14 providing 81% sensitivity and 80% specificity for predicting severe LEAD. Conclusion: The HALP score is a valuable, non-invasive predictor of LEAD severity and may serve as a practical tool for clinical risk assessment. Incorporating the HALP score into routine evaluation protocols could support more personalized management approaches for patients with LEAD, guiding both therapeutic decisions and long-term monitoring.

Contrast-induced nephropathy (CIN) significantly increases morbidity and mortality among acute myocardial infarction (MI) patients undergoing coronary angiography (CAG). This study evaluated the predictive value of serum uric acid (SUA) and C-reactive protein/albumin ratio (CAR) for CIN development. A retrospective analysis included 1326 acute MI patients who underwent CAG between November 2022 and January 2024. CIN occurred in 119 patients (9.0%). Higher SUA (5.60 vs 4.60 mg/dL, P < .001) and CAR (2.79 vs 2.15, P = .004) were significantly associated with CIN. Multivariate analysis confirmed SUA (Odds Ratio [OR]: 1.577, P < .001) and contrast volume (OR: 1.014, P < .001) as independent predictors. Receiver Operating Characteristic (ROC) analysis identified optimal SUA cutoff at 4.9 mg/dL (sensitivity 67.7%, specificity 68.1%). The predictive value of SUA was stronger among diabetic patients. Additionally, SUA positively correlated with CAR ( r = .41, P < .001). A simplified risk score incorporating SUA, CAR, contrast volume, diabetes, and age effectively stratified CIN risk. Elevated SUA levels and high CAR independently predict CIN in acute MI patients, enhancing clinical risk stratification and guiding preventive strategies.