Prognostic value of the Aggregate Index of Systemic Inflammation for 12-month major adverse cardiovascular events in patients with STEMI undergoing primary PCI

İsmail Balaban; Seda Tanyeri Uzel; Barkın Kültürsay; Mustafa Ferhat Keten; Kadir Bıyıklı

Prognostic value of the Aggregate Index of Systemic Inflammation for 12-month major adverse cardiovascular events in patients with STEMI undergoing primary PCI

Abstract

Aims: ST-segment elevation myocardial infarction (STEMI) remains a major cause of morbidity and mortality despite advances in reperfusion strategies. Systemic inflammation plays a key role in the pathophysiology of acute myocardial infarction and may influence long-term outcomes. The Aggregate Index of Systemic Inflammation (AISI) is a novel composite biomarker reflecting overall inflammatory burden. However, its prognostic value in STEMI patients undergoing primary percutaneous coronary intervention (PCI) remains insufficiently explored. Methods: In this retrospective, single-center cohort study, a total of 1.224 patients with STEMI who underwent primary PCI between November 2022 and April 2025 were included. AISI was calculated using admission hematological parameters, and patients were stratified into tertiles. The primary endpoint was major adverse cardiovascular events (MACE), defined as a composite of all-cause mortality, reinfarction, and repeat revascularization at 12 months. Cox proportional hazards models were used to identify independent predictors of MACE. Restricted cubic spline (RCS) analysis was performed to assess non-linear associations, and AISI was log-transformed for further modeling. Results: During a 12-month follow-up, the incidence of MACE increased significantly across AISI tertiles (14.2%, 16.7%, and 23.0%, respectively; p=0.003). In univariate analysis, higher AISI levels were associated with increased risk of MACE. In multivariable Cox regression analysis, AISI remained an independent predictor of MACE (HR: 1.001, 95% CI: 1.000-1.001, p=0.001). Restricted cubic spline (RCS) analysis demonstrated a non-linear association between AISI and MACE (p for non linearity <0.05). Log-transformed AISI showed a stronger association with outcomes (HR: 1.395, 95% CI: 1.181-1.647, p<0.001). Kaplan-Meier analysis revealed significantly lower MACE-free survival in patients with higher AISI tertiles (log-rank p=0.017). Subgroup analyses suggested broadly similar trends across clinically relevant subgroups; however, these findings should be interpreted as exploratory because formal interaction testing was not performed. Conclusion: AISI is an independent and robust predictor of 12-month MACE in patients with STEMI undergoing primary PCI. Its independent association with outcomes, together with the improved model fit observed after log-transformation, suggests that AISI may serve as a simple and practical biomarker for early risk stratification. Further prospective studies are warranted to validate these findings.

Keywords

References

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Details

Primary Language

English

Subjects

Cardiology

Journal Section

Research Article

Authors

İsmail Balaban ^*
0000-0002-1866-349X
Türkiye

Seda Tanyeri Uzel
0000-0002-0933-9233
Türkiye

Barkın Kültürsay
0000-0002-1424-2209
Türkiye

Mustafa Ferhat Keten
0000-0003-2646-4981
Türkiye

Kadir Bıyıklı
0000-0002-0841-1301
Türkiye

Publication Date

July 16, 2026

Submission Date

May 2, 2026

Acceptance Date

July 8, 2026

Published in Issue

Year 2026 Volume: 8 Number: 4

IZ

https://izlik.org/JA52BH22EU

Cite

RIS / Bibtex

APA

Balaban, İ., Tanyeri Uzel, S., Kültürsay, B., Keten, M. F., & Bıyıklı, K. (2026). Prognostic value of the Aggregate Index of Systemic Inflammation for 12-month major adverse cardiovascular events in patients with STEMI undergoing primary PCI. Anatolian Current Medical Journal, 8(4), 787-796. https://izlik.org/JA52BH22EU

AMA

1.Balaban İ, Tanyeri Uzel S, Kültürsay B, Keten MF, Bıyıklı K. Prognostic value of the Aggregate Index of Systemic Inflammation for 12-month major adverse cardiovascular events in patients with STEMI undergoing primary PCI. Anatolian Curr Med J / ACMJ / acmj. 2026;8(4):787-796. https://izlik.org/JA52BH22EU

Chicago

Balaban, İsmail, Seda Tanyeri Uzel, Barkın Kültürsay, Mustafa Ferhat Keten, and Kadir Bıyıklı. 2026. “Prognostic Value of the Aggregate Index of Systemic Inflammation for 12-Month Major Adverse Cardiovascular Events in Patients With STEMI Undergoing Primary PCI”. Anatolian Current Medical Journal 8 (4): 787-96. https://izlik.org/JA52BH22EU.

EndNote

Balaban İ, Tanyeri Uzel S, Kültürsay B, Keten MF, Bıyıklı K (July 1, 2026) Prognostic value of the Aggregate Index of Systemic Inflammation for 12-month major adverse cardiovascular events in patients with STEMI undergoing primary PCI. Anatolian Current Medical Journal 8 4 787–796.

IEEE

[1]İ. Balaban, S. Tanyeri Uzel, B. Kültürsay, M. F. Keten, and K. Bıyıklı, “Prognostic value of the Aggregate Index of Systemic Inflammation for 12-month major adverse cardiovascular events in patients with STEMI undergoing primary PCI”, Anatolian Curr Med J / ACMJ / acmj, vol. 8, no. 4, pp. 787–796, July 2026, [Online]. Available: https://izlik.org/JA52BH22EU

ISNAD

Balaban, İsmail - Tanyeri Uzel, Seda - Kültürsay, Barkın - Keten, Mustafa Ferhat - Bıyıklı, Kadir. “Prognostic Value of the Aggregate Index of Systemic Inflammation for 12-Month Major Adverse Cardiovascular Events in Patients With STEMI Undergoing Primary PCI”. Anatolian Current Medical Journal 8/4 (July 1, 2026): 787-796. https://izlik.org/JA52BH22EU.

JAMA

1.Balaban İ, Tanyeri Uzel S, Kültürsay B, Keten MF, Bıyıklı K. Prognostic value of the Aggregate Index of Systemic Inflammation for 12-month major adverse cardiovascular events in patients with STEMI undergoing primary PCI. Anatolian Curr Med J / ACMJ / acmj. 2026;8:787–796.

MLA

Balaban, İsmail, et al. “Prognostic Value of the Aggregate Index of Systemic Inflammation for 12-Month Major Adverse Cardiovascular Events in Patients With STEMI Undergoing Primary PCI”. Anatolian Current Medical Journal, vol. 8, no. 4, July 2026, pp. 787-96, https://izlik.org/JA52BH22EU.

Vancouver

1.İsmail Balaban, Seda Tanyeri Uzel, Barkın Kültürsay, Mustafa Ferhat Keten, Kadir Bıyıklı. Prognostic value of the Aggregate Index of Systemic Inflammation for 12-month major adverse cardiovascular events in patients with STEMI undergoing primary PCI. Anatolian Curr Med J / ACMJ / acmj [Internet]. 2026 Jul. 1;8(4):787-96. Available from: https://izlik.org/JA52BH22EU