Background: Inflammation is considered to play an important role in chronic obstructive pulmonary disease (COPD) and acute myocardial infarction (AMI), but the relationship between inflammation and poor prognosis in these patients has not yet been studied.Methods: We enrolled AMI patients combined with COPD and divided them into three groups according to the tertiles of neutrophil-to-lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and monocyte to lymphocyte ratio (MLR) respectively. Logistic regression analyses were used to identify risk factors for in-hospital all-cause death in these patients. Covariates were adjusted stepwise to determine the association between inflammatory markers and poor prognosis. Also, the receiver operating characteristic (ROC) curve was used to evaluate the greatest predictive indicator for all-cause death.Results: A total of 281 AMI patients combined with COPD were enrolled, of which 31 experienced in-hospital mortality. The risk of all-cause death was significantly higher among those with higher NLR. The highest tertile of NLR was significantly associated with an increased risk of all-cause death (all P < 0.05). This association remained significant after adjusting for confounding factors [Odds Ratio (OR): 10.571, 95% confidence interval (CI): 2.307–48.442, P = 0.002]. Moreover, compared to MLR and PLR, NLR had the highest predictive value for all-cause death [area under the curve (AUC): 0.764, 95% CI: 0.681–0.847].Conclusion: In AMI patients combined with COPD, elevated levels of inflammation were associated with increased all-cause mortality. Compared to other inflammatory indicators, NLR may provide a more superior predictive value.

Background: Gastrointestinal bleeding (GIB) is one of the most serious complications of acute myocardial infarction (AMI) and is correlated with poor outcomes.Objective: To evaluate the prevalence, risk factors and in-hospital mortality of GIB in patients with AMI.Methods: This observational case-control study retrospectively enrolled consecutive patients with AMI from the Department of Cardiovascular Medicine and Cardiovascular Surgery of the First Affiliated Hospital of Xi'an Jiaotong University from January 2015 to December 2020. GIB after AMI was identified by International Classification of Diseases (ICD) codes from inpatient medical settings and validated by medical record review. AMI patients without GIB were accordingly classified as the control group. Propensity score matching (PSM) was used to match with the GIB group and the control group. All anonymized clinical data were provided by the Biobank of the First Affiliated Hospital of Xi'an Jiaotong University.Results: A total of 5,868 AMI patients were enrolled, 0.87% (51/5,868) of whom developed GIB after AMI. On the univariate analysis, history of diabetes, chronic kidney disease, Killip IV, a lower hemoglobin concentration, a higher serum level of creatinine, blood urea nitrogen and D-dimer were closely associated with the risk of GIB (P < 0.05). On the multivariable analysis, a lower hemoglobin concentration (OR: 0.93, 95% CI: 0.89–0.96, P < 0.001) was independently associated with the risk of GIB. Patients with GIB had a much higher in-hospital mortality rate than those without GIB (14.3 vs. 2.1%, P = 0.047). In-hospital mortality among patients with GIB after AMI appeared to be associated with a decreased hemoglobin concentration (OR: 0.93, 95% CI: 0.86–0.99, P = 0.045) and Killip IV (OR: 51.59, 95% CI: 2.65–1,005.30, P = 0.009).Conclusion: The history of diabetes, poor renal function and heart failure were associated with the high risk of GIB in patients experiencing AMI. The in-hospital mortality in patients with AMI complicating GIB was higher than that in patients without GIB and was associated with a decreased hemoglobin concentration and high Killip classification.

Background: Dilated cardiomyopathy (DCM) is characterized by left ventricular dilation and systolic dysfunction in the absence of severe hypertension, valvular disease, or coronary artery disease. Patients with DCM have a high risk of atrial fibrillation (AF), especially when combined with Type 2 diabetes mellitus (T2DM). Sodium‐glucose cotransporter 2 inhibitors (SGLT2i) have shown cardioprotective effects in patients with diabetes, suggesting potential benefits in reducing AF incidence. Methods: We retrospectively analyzed clinical data from patients with T2DM diagnosed with DCM treated at the First Affiliated Hospital of Xi’an Jiaotong University between January 2018 and January 2024. Patients were divided into two groups based on their use of SGLT2i. The incidence of AF was compared between these groups using logistic regression models adjusted for potential confounders, including demographic characteristics, comorbidities, and medication history. Additionally, a subgroup analysis was conducted to evaluate the relationship between AF and SGLT2i. Results: Among 455 enrolled patients, 95 (20.9%) were treated with SGLT2i. The incidence of AF was significantly lower in the SGLT2i group compared with the control group (7/95 [7.4%] vs. 68/360 [18.9%]; OR = 0.308, 95 % CI = 0.132–0.735, p = 0.008). Subgroup analyses showed consistent results across various age, gender, hypertension status, and diabetes duration groups, indicating the robustness of the association between SGLT2i use and reduced AF incidence. Conclusion: Our study suggests that SGLT2i use is associated with a lower incidence of AF in patients with T2DM and DCM. This observed association warrants further investigation in prospective studies to elucidate its nature.

Background/Objectives: Acute liver injury (ALI) is a severe complication of acute myocardial infarction (AMI) comorbid with type 2 diabetes mellitus (T2DM), serving as an independent risk factor for adverse prognosis and imposing a significant disease burden. The aim of this study was to identify predictive value of a composite of inflammation and nutrition-related indicators for the risk of ALI in AMI patients comorbid with T2DM.Methods: AMI patients with T2DM hospitalized at the First Affiliated Hospital of Xi’an Jiaotong University between January 2018 and May 2025 were included. Clinical data and medication information were collected through the hospital’s biospecimen information resource center. The patients enrolled were divided into non-hepatic injury group, mild hepatic injury group and moderate-to-severe hepatic injury group according to the alanine transaminase (ALT) level tested during hospitalization. Neutrophil percentage-to-albumin ratio (NPAR) was calculated as the ratio of neutrophil percentage (NP) to serum albumin (ALB) level (NPAR = NP/ALB). The primary outcome is acute liver injury during hospitalization.Results: Among 5133 AMI patients with T2DM (76.57% male, median age 62.61 years (51.29–72.93), acute liver injury occurred in 7.60% (n = 390) of the cohort and moderate-to-severe hepatic injury occurred in 1.34% (n = 69). Compared with non - hepatic injury, mild (60.7% vs. 45.2%, P < 0.001) and moderate-to-severe hepatic injury (65.2% vs. 45.2%, P < 0.001) had higher ST - segment elevation myocardial infarction (STEMI) rates. Both hepatic injury subgroups showed higher Killip III/IV prevalence (mild: 26.2% vs. 8.7%, moderate-to-severe: 53.6% vs. 8.7%, both P < 0.001). Moderate-to-severe vs. mild injury had older age (69.50 ± 11.79 vs. 64.35 ± 11.77, P < 0.05) and more arrhythmias (46.4% vs. 27.1%, P < 0.001). After adjustment, NPAR independently predicted ALI (OR = 1.70, 95% CI: 1.33–2.17) and moderate-to-severe injury (OR = 2.90, 95% CI: 1.90–4.42), with an AUC of 0.86 (95% CI: 0.81–0.92) for moderate-to-severe injury. A history of cancer was an independent risk factor for ALI. Among these patients, NPAR demonstrated AUCs of 0.83 for overall ALI and 0.89 for moderate-to-severe ALI.Conclusion: NPAR effectively predicts moderate-to-severe hepatic injury in AMI patients with T2DM, suggesting its potential as a clinically useful early marker. Furthermore, while cancer is an independent risk factor for ALI in this population, NPAR maintains strong predictive performance for ALI even in this high-risk subgroup.

Background: The incidence of acute myocardial infarction (AMI) in young adults (<45 years) is increasing. Pericardial effusion (PE) is a notable complication reflecting hemodynamic instability and severe inflammation; however, sensitive biomarkers for early risk stratification in this specific demographic remain under-investigated. The N-terminal pro-B-type natriuretic peptide to albumin ratio (NT-proBNP/ALB) integrates hemodynamic load with inflammatory-nutritional status, yet its prognostic utility for PE in young AMI patients is unexplored. Methods: This retrospective observational study enrolled 1,974 young AMI patients admitted to the First Affiliated Hospital of Xi'an Jiaotong University between January 2018 and October 2025. Patients were categorized into PE and non-PE groups based on echocardiographic findings. Multivariate logistic regression was utilized to identify independent predictors. The incremental predictive value of the log-transformed NT-proBNP/ALB ratio (lg BNP/ALB) and Plateletcrit (PCT, a platelet mass marker) was evaluated using Receiver Operating Characteristic (ROC) curves, Net Reclassification Improvement (NRI), and Integrated Discrimination Improvement (IDI). Results: In-hospital PE occurred in 7.1% (141/1,974) of the cohort. Multivariate analysis identified lg (NT-proBNP/ALB) (adjusted OR: 3.23, 95% CI: 1.30–5.78, P < 0.001) and PCT (adjusted OR: 1.87, 95% CI: 1.08–3.23, P = 0.025) as independent risk factors, alongside STEMI, LVEF, eGFR, and total cholesterol. The incorporation of lg (NT-proBNP/ALB) and PCT into a baseline clinical model significantly improved the Area Under the Curve (AUC) from 0.718 to 0.849 ( P < 0.001). Furthermore, reclassification analyses confirmed significant improvements in risk stratification, with a categorical NRI of 0.2198 ( P < 0.001) and an IDI of 0.1116 ( P < 0.001). Conclusion: The admission NT-proBNP/ALB ratio and PCT were independently associated with in-hospital pericardial effusion in young AMI patients and provided incremental value for early risk stratification beyond conventional clinical indicators.