Evidence map›Paper›PMID 41857508›Full record

ArticleBMC cardiovascular disorders2026

Endothelial Activation and Stress Index (EASIX) as a novel index associated with no-reflow phenomenon in STEMI: a bi-center retrospective study.

Emre Melik Faideci, Emirhan Hancıoğlu, Murat Ziyrek, Sevgi Özcan, Sinan Güzel, Mehmet Emin Alak, Ramazan Aslan, İsa Ardahanlı, Çağatay Ertan, İrfan Şahin and 1 more

Abstract readMulticenter Study
In one paragraph

Article in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Emre Melik FaideciCardiology Clinic, Bilecik Training and Research Hospital, Pelitözü District, Central Bilecik, Bilecik, 11000, Turkey. dr.emremelik@gmail.com.ORCID http://orcid.org/0000-0002-0272-9271
Emirhan HancıoğluCardiology Clinic, Acıbadem Branch, Medipol University Hospital, Acıbadem, Şehit Emin Çölen Street, No:18, Kadıköy, Istanbul, 34718, Turkey.ORCID http://orcid.org/0000-0001-8209-217X
Murat ZiyrekCardiology Clinic, Karatay University Hospital, Akademi District, Yeni Istanbul Street, Selçuklu, Konya, 42100 , Turkey.ORCID http://orcid.org/0000-0003-4032-7561
Sevgi ÖzcanCardiology Clinic, Istanbul Bağcılar Training and Research Hospital, Istanbul, Turkey.ORCID http://orcid.org/0000-0002-0201-8314
Sinan GüzelDepartment of Cardiovascular Surgery, Kayseri State Hospital, Seyyid Burhanettin Boulevard, No:1, Kocasinan, Kayseri, 38010, Turkey.ORCID http://orcid.org/0000-0001-6564-2360
Mehmet Emin AlakCardiology Clinic, Istanbul Bağcılar Training and Research Hospital, Istanbul, Turkey.ORCID http://orcid.org/0000-0002-1278-6608
Ramazan AslanCardiology Clinic, Bilecik Training and Research Hospital, Pelitözü District, Central Bilecik, Bilecik, 11000, Turkey.ORCID http://orcid.org/0000-0002-1255-7880
İsa ArdahanlıCardiology Clinic, Bilecik Training and Research Hospital, Pelitözü District, Central Bilecik, Bilecik, 11000, Turkey.ORCID http://orcid.org/0000-0002-9309-803X
Çağatay ErtanCardiology Clinic, Bilecik Training and Research Hospital, Pelitözü District, Central Bilecik, Bilecik, 11000, Turkey.ORCID http://orcid.org/0000-0003-0655-0380
İrfan ŞahinCardiology Clinic, Istanbul Bağcılar Training and Research Hospital, Istanbul, Turkey.ORCID http://orcid.org/0000-0001-9165-7566
Ertuğrul OkuyanCardiology Clinic, Medipol University, Hospital, TEM Avrupa Motorway Göztepe Exit No:1, Bağcılar, Istanbul, 34214, Turkey.ORCID http://orcid.org/0000-0002-0626-2939

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionNo-reflow phenomenon (NRP) after primary PCI in STEMI is strongly linked to early mortality and adverse events. Conventional indices such as the systemic immune-inflammation index (SII), the CRP to albumin ratio (CAR), and the SYNTAX 1 score (SXscore) appear to provide only moderate discrimination for NRP. The endothelial activation and stress index (EASIX), calculated as LDH × creatinine / platelet count, reflects endothelial dysfunction and microvascular stress and may add to risk stratification. MATERIALS AND

methodsThis two-center retrospective cohort study included 983 consecutive STEMI patients undergoing primary PCI. NRP was defined as the failure to achieve distal TIMI 3 flow despite a fully patent epicardial artery, or the need for pharmacological therapy to reverse NRP. We evaluated the relationships of EASIX, SII, CAR and SXscore with NRP; key exclusion criteria were non-ticagrelor P2Y12 loading, advanced renal/hepatic failure, active infection/inflammatory–hematologic disease or malignancy, shock/arrest (Killip ≥ 2), door-to-balloon time > 60 min, prior CABG/PCI, and pre-PCI fibrinolytic therapy.

resultsNRP occurred in 267 patients (27.2%). EASIX, SII, CAR and SXscore were significantly higher in the NRP (+) group (all p < 0.001). In multivariable models, EASIX (OR 18.97, 95% CI 11.83–30.43; p < 0.001), CAR (OR 2.45, 95% CI 1.90–3.16; p < 0.001), SII (OR 1.000, 95% CI 1.000–1.000; p = 0.003), and SXscore (OR 1.04, 95% CI 1.03–1.06; p < 0.001) were independently associated with NRP. In ROC analysis, EASIX demonstrated the highest discriminative ability for predicting NRP (AUC = 0.835). The optimal cut-off value of 1.248 provided 62.2% sensitivity and 93.6% specificity. In comparison, CAR, SII, and SXscore showed lower discrimination (AUC = 0.687, 0.562, and 0.583, respectively).

conclusionEASIX demonstrated a stronger association with NRP than CAR, SII, and the SXscore. Easily derived from routine laboratory tests, EASIX may represent a practical and readily applicable index for early NRP risk stratification in STEMI.

Indexed as

Coronary CirculationEndothelium, VascularNo-Reflow PhenomenonPercutaneous Coronary InterventionST Elevation Myocardial InfarctionAgedBiomarkersCoronary AngiographyCreatinineFemaleHumansMaleMiddle AgedPlatelet CountPredictive Value of TestsRetrospective StudiesBiomarkersCreatinineEASIXNo-reflowPCISTEMI

Identifiers

PMID41857508
PMCPMC13122968

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.