The predictive value of creatinine to ejection fraction ratio for short-term mortality in elderly patients with ST-segment elevation myocardial infarction
LU Ping
WU YU-ting
HE YU-ying
LIAO You-wan
Abstract：Background: Elderly patients (age ≥ 60 years) with ST-segment elevation myocardial infarction (STEMI) are at an elevated risk of mortality. This study aimed to investigate the association of the creatinine to ejection fraction ratio (CER) with in-hospital and 1-year death in elderly patients with STEMI. Methods: A total of 753 consecutive elderly patients (age ≥ 60 years) with STEMI undergoing percutaneous coronary intervention (PCI) were enrolled and divided into three groups according to the tertiles of CER at admission: <1.5 (n=250), 1.5-2.2 (n=249), and >2.2 (n=254). Multivariate analyses were performed to evaluate the prognostic value of CER for short-term death in this population. Results: The in-hospital and 1-year mortality reached 6.0% and 13.3%, respectively. Patients with higher CER exhibited a higher in-hospital mortality (0.8% vs. 2.8% vs. 14.2%, P < 0.001). An optimal cut-off value of 2.5 for CER was identified for predicting in-hospital death by receiver operating characteristic curve analysis, yielding a sensitivity of 77.8% and a specificity of 76.1% [area under curve (AUC): 0.791, 95% confidence interval (CI): 0.734-0.847, P < 0.001]. Multivariate regression analyses revealed that CER > 2.5 was an independent risk factor for both in-hospital [adjusted odds ratio (OR): 9.006, 95% CI: 2.707-29.967, P < 0.001] and 1-year mortality [adjusted hazard ratio (HR): 5.082, 95% CI: 2.462-10.490, P < 0.001]. Conclusions: Elevated CER is associated with adverse short-term mortality in elderly STEMI patients undergone PCI, offering valuable insights for the early identification and management of high-risk individuals in clinical practice. [S Chin J Cardiol 2025;26(3):155-163]
Keywords：Creatinine to ejection fraction ratioST-segment elevation myocardial infarctionElderlyShort-term mortality
Publication Date：2025-09-30
Online Publishing Date：2025-11-03(First online date of this platform, not the publication date of the document)
Pages：9( 155-163 )