The modified cardiometabolic index as a risk factor for mortality after percutaneous coronary intervention in acute myocardial infarction

The cardiometabolic index (CMI) serves as an integrative measure of both obesity and dyslipidemia. This study aimed to evaluate whether an elevated modified cardiometabolic index (MCMI) is related to the risk of all-cause mortality (ACM) and cardiovascular mortality (CVM) after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). This large-scale retrospective cohort study utilized data from 2,688 participants with AMI undergoing PCI between June 2015 and June 2020 at Zhongda Hospital Southeast University and conducted follow-up. The MCMI, integrating high-density lipoprotein cholesterol, waist circumference, triglycerides, and fasting blood glucose, was used as a composite marker of cardiometabolic risk. After adjusting for potential confounding, restricted cubic splines (RCS), subgroup analyses, and Cox proportional hazards models were utilized to evaluate the associations of MCMI with ACM and CVM. Receiver operating characteristic (ROC) curve analysis was used to assess its diagnostic value. In total, 2,688 participants with AMI were enrolled (mean age 54.47 ± 18.41 years, 50.9% male). The RCS plot revealed a positive linear association between MCMI and the risk of ACM and CVM in participants after AMI (all P for overall < 0.001). After adjusting for known confounders, compared with the lowest MCMI quartile, the hazard ratios (95% CIs) for ACM in the second, third, and fourth quartiles were 1.40 (1.07, 1.83), 1.53 (1.18, 1.99) and 1.55 (1.18, 2.03), respectively. The corresponding values for CVM were 1.32 (1.03, 2.06), 1.53 (1.15, 2.18) and 1.73 (1.21, 2.24). Finally, MCMI demonstrated better predictive ability for ACM and CVM in patients with AMI after PCI (AUC = 0.811; AUC = 0.828). In conclusion, this study demonstrates that among AMI patients, high MCMI was independently related to a greater risk of ACM and CVM. This finding establishes MCMI as a significant prognostic marker, which can aid in risk stratification and guide more aggressive secondary prevention strategies for high-risk individuals.