A significant predictor of in-hospital and long-term mortality and progression in COVID-19 patients: The end-stage liver disease (MELD) score model.

The aim of this study is to investigate the relationship between the model for end-stage liver disease (MELD) score and disease progression and mortality in COVID-19 patients. The files of 4213 patients over the age of 18 who were hospitalized with the diagnosis of COVID-19 between March 20, 2020 and May 1, 2021 were retrospectively scanned. Sociodemographic characteristics, chronic diseases, hemogram and biochemical parameters at the time they were diagnosed with COVID-19 of the patients, duration of hospitalization, duration of intensive care unit (ICU), duration of intubation, in-hospital mortality from COVID-19 and outside-hospital mortality for another reason (within the last 1 year) and recurrent hospitalization (within the last 1 year) were recorded. The MELD scores of the patients were calculated. Two groups were formed as MELD score < 10 and MELD score ≥ 10. The rate of ICU, in-hospital mortality from COVID-19 and outside-hospital mortality from other causes, intubation rate, and recurrent hospitalization were significantly higher in the MELD ≥ 10 group. The duration of ICU, hospitalization, intubation were significantly higher in the MELD ≥ 10 group (p < 0.001). As a result of Univariate and Multivariate analysis, MELD score was found to be the independent predictors of ICU, in-hospital mortality, intubation, and recurrent hospitalization (p < 0.001). MELD score 18.5 predicted ICU with 99% sensitivity and 100% specificity (area under curve [AUC]: 0.740, 95% confidence interval [CI]: 0.717-0.763, p < 0.001) also MELD score 18.5 predicted in-hospital mortality with 99% sensitivity and 100% specificity (AUC: 0.797, 95% CI: 0.775-0.818, p < 0.001). The MELD score was found to be the independent predictors of in-hospital mortality, ICU admission, and intubation in COVID-19 patients.

Association between previous anticoagulant use and mortality among hospitalized patients with COVID-19.

Although COVID-19 disease primarily affects the respiratory system, it has been seen in many studies that it causes thromboembolic (TE) events in many tissues and organs. So that, to prevent TE can reduce mortality and morbidity. In this context, this study aimed to investigate the relationship between the previous use of warfarin or other new direct oral anticoagulants (OAC) and mortality in patients hospitalized with a diagnosis of COVID-19 before hospitalization. A total of 5575 patients who were diagnosed with COVID-19 were hospitalized and started treatment between March 21 and November 30, 2020 were included in the study. The primary outcome was in-hospital all-cause mortality. A retrospective cohort study design was planned. Patients were followed up until death or censoring on November 30, 2020. The candidate predictors for primary outcome should be clinically and biologically plausible, and their relationships with all-cause death should be demonstrated in previous studies. We considered all candidate predictors included in the model in accordance with these principles. The main candidate predictor was previous OAC use. The primary analysis method was to compare the time to deaths of patients using and not using previous OAC by a multivariable Cox proportional hazard model (CPHM). In the CPHM, previous OAC use was found to be associated with a significantly lower mortality risk (adjusted hazard ratio 0.62, 95% CI 0.42-0.92, p = 0.030). In hospitalized COVID-19 patients, in patients who previously used anticoagulantswas associated with lower risk of in-hospital death than in those who did not.

The relationship between pericardial effusion and pulmonary involvement, prognosis, mortality in COVID-19 patients.

Aim    Comprehensive studies on the coexistence of COVID-19 and pericardial effusion (PEff) are limited. In this study, we investigated the relationship between pneumonia severity and PEff, predisposing factors, and the effect of PEff on clinical prognosis and mortality in COVID-19 patients.Material and methods    Between March and November 2020, 5 575 patients were followed up in our pandemic hospital due to COVID-19. 3 794 patients with positive polymerase chain reaction (PCR) test results and thoraxcomputerized tomography (CT) imaging at admission were included in the study. The clinical and demographic characteristics, CT images, hematological and biochemical parameters of these patients were retrospectively examined. Pulmonary involvement of 3794 patients was divided into three groups and its relationship with PEff was investigated retrospectively.Results    There were 560 patients who did not have pulmonary involvement, 2 639 patients with pulmonary involvement below 50 %, and 595 patients with 50 % or more pulmonary involvement. As pulmonaryinvolvement or the severity of the disease increased, male gender and advanced age become statistically significant. The mean age of patients with PEff was higher, and PEff was more common in males. Patients with PEff had more comorbid diseases and significantly elevated serum cardiac and inflammatory biomarkers. The need for intensive care and mortality rates were higher in these patients. While the in-hospital mortality rate was 56.9 % in patients with PEff and pulmonary involvement above 50 %, in-hospital mortality rate was 34.4 % in patients with pulmonary involvement above 50 % and without PEff (p<0.001).The presence of PEff during admission for COVID-19 disease, the appearance of PEff or increase in the degree of PEff during follow-up were closely related to mortality and prognosis.Conclusion    As the severity of pulmonary involvement or the clinical severity of the disease increased, PEff occurred in patients or the degree of PEff increased. The clinical prognosis of patients presenting with PEff was quite poor, and the frequency of intensive care admissions and mortality were significantly higher. PEff was an important finding in the follow-up and management of patients with COVID-19, and it reflected the clinical prognosis.

Modified model for end-stage liver disease score predicts 30-day mortality in high-risk patients with acute pulmonary embolism admitted to intensive care units.

OBJECTIVES: The Model for End-stage Liver Disease excluding the international normalised ratio that is derived from prothrombin time which is calculated as a ratio of the patient's prothrombin time to a control prothrombin time standardized (MELD-XI) and modified MELD, which uses albumin in place of the international normalised ratio (MELD-Albumin) scores reflect liver and renal function and are predictors of mortality. However, their prognostic value in acute pulmonary embolism (APE) has not been studied. DESIGN: We assessed the predictive value of the MELD scores in patients diagnosed with high-risk APE admitted to the intensive care unit. The primary outcome was 30-day mortality. RESULTS: Of the 273 patients included in the study, 231 were survivors and 42 were non-survivors. The mortality rate was 15.3%. The mean MELD-XI and MELD-Albumin scores were significantly higher in the non-survivors than in the survivors (MELD XI, 11.8 ± 1.8 and 10.6 ± 1.43, respectively; p = .002; MELD-Albumin, 10.5 ± 1.6 and 8.7 ± 1.1, respectively; p = .001). The multiple logistic regression analysis identified the MELD-XI (hazard ratio: 3.029, confidence interval: 1.06-1.21, p = .007) and MELD-Albumin (hazard ratio: 1.13, confidence interval: 1.06-1.21, p = .002) scores as independent predictors of mortality. Receiver operating characteristic analysis revealed that the predictive power of the MELD-Albumin score (0.871 ± 0.014; p < .001) was higher than those of the MELD-XI (0.726 ± 0.022, p < .001), APACHE III (0.682 ± 0.024, p < .001), and PESI (0.624 ± 0.023, p < .001) scores. CONCLUSIONS: The MELD-Albumin score is an easily calculable, reliable, and practical risk assessment tool and independent predictor of 30-day mortality in patients with high-risk APE.

Assessment of right ventricular dysfunction in patients with mitral stenosis: A speckle tracking study.

PURPOSE: Although it is affected at an early stage, there is a lack of studies investigating right ventricular (RV) function in patients with mitral stenosis (MS). We aimed to investigate the correlation between conventional echocardiographic variables and tricuspid annular plane systolic excursion (TAPSE), used as an indicator of RV dysfunction. METHODS: We enrolled 59 consecutive patients with MS and assigned them in group 1 if TAPSE ≤16, or group 2 if: TAPSE >16. RESULTS: The mean age of the patients was 42.2 ± 8 years, and 74.6% were females. In univariate analysis, maximal mitral valve gradient, mean mitral valve gradient, systolic pulmonary arterial pressure, RV strain, and RV strain rates were associated with RV dysfunction. In multivariate analysis, both strain variables were found to be independent predictors of RV dysfunction. Kaplan Maier survival analysis showed that patients with lower RV strain had more rehospitalization rate during the one-year follow-up period. CONCLUSIONS: RV dysfunction is common in patients with MS and is associated with higher rehospitalization rate and morbidity. Evaluation of RV strain and strain rate for early detection of RV dysfunction and prediction of rehospitalization may be an appropriate approach in mitral stenosis.

The association between CRP / Albumin ratio and in-stent restenosis development in patients with ST-segment elevation myocardial infarction.

BACKGROUND: Although interventional methods are the first-line treatment options in ST-segment elevation myocardial infarction (STEMI), the incidence of stent restenosis (SR) is frequent. We investigated the relationship between CRP/albumin ratio (CAR), a novel indicator of inflammatory response, and SR in this study. METHOD: This study was carried out on the patients who underwent coronary angiography in our clinic between January 2017 and September 2017. Two groups were generated according to restenosis status (group 1: restenosis (-), group 2: restenosis (+)), and clinical biochemical and angiographical features were compared. As baseline demographic and angiographic characteristics are slightly different in two groups, propensity score matching analysis was performed to reduce bias. 45 SR patients were matched on a 1:1 basis were enrolled final cohort. RESULTS: The mean age of the patients was 55 ± 5.1 and 80% were male; Cox regression model was performed to demonstrate independent predictor of restenosis development; and during the one-year follow-up period, CAR (P < 0.001) was found an independent predictor of SR CONCLUSION: In this study, we demonstrate that there may be a strong relationship between SR development and CAR. We implied that inflammatory reaction may be an important diagnostic tool for prediction of SR development in STEMI patients.

Evaluation of ventricular repolarization parameters during migraine attacks.

AIMS: Migraine is a chronic neurovascular disorder characterized by intermittent episodes of severe headache. Abnormalities in the autonomic nervous system (sympathetic and parasympathetic nervous systems) have been detected during migraine-free periods in patients with migraine. In these patients, disrupted autonomic innervations of the heart and coronary arteries may lead to electrocardiographic changes during a migraine attack. T-wave peak-to-end interval (Tp-e interval) and Tp-e/QT ratio are relatively new markers of ventricular arrhythmogenesis and repolarization heterogeneity. In the present observational study, we investigated the changes in ventricular repolarization during migraine attacks and attack-free periods by performing 12­lead electrocardiography (ECG). METHODS: This study included 63 patients (54 [86%] women; mean age: 33.3 ±â€¯9.9 years) with migraine. The QT and corrected QT (QTc) intervals, Tp-e interval, and Tp-e/QT ratio of the patients during migraine attacks and attack-free periods were measured by performing 12­lead ECG. RESULTS: The QT and QTc intervals, Tp-e interval, and Tp-e/QT ratio were higher during migraine attacks than during attack-free periods (P < 0.001 for all). CONCLUSION: These results indicate that migraine attacks are associated with an increase in ventricular repolarization parameters compared with attack-free periods possibly because of the dysregulation of the autonomic nervous system.

The role of the right atrium in development of postoperative atrial fibrillation: A speckle tracking echocardiography study.

PURPOSE: Atrial fibrillation (AF) is relatively frequent in the postoperative period, and is associated with an increased frequency of adverse events. The role of right atrial (RA) volume and functions in the development of AF is unknown. In this study, we investigated the effect of RA echocardiographic indices on AF development in the postoperative period. METHOD: We enrolled 142 consecutive patients who underwent coronary artery bypass surgery, and assigned them into two groups depending on the occurrence or not of AF development in the postoperative period. RESULTS: A propensity score matching analysis was performed to balance the groups, and 37 pairs were eventually included in the analysis. The median age was 67.5 (63-75) years and 73.3% of them were males. In the univariate analysis, right atrial volume index (RAVi), right atrial strain during reservoir phase (RASr), left ventricular global longitudinal strain, right ventricular strain, left atrial volume index, left atrial strain during reservoir phase, and systolic pulmonary artery pressure were associated with AF development. In the regression analysis, we found that RAVi (OR: 3.1, 95% CI: 2.2-6.3, P: .033) and RASr (OR: 0.82, 95% CI: 0.67-0.93, P: .048) were independent predictors of AF development. CONCLUSIONS: RA structure and functions are closely associated with AF development in the postoperative period, and screening of RA functions prior to surgery may be useful for preventing AF development.

Acute cardiac effects of high dose steroid treatment: A speckle tracking echocardiography study.

PURPOSE: High-dose steroid therapy (HDST) has frequent side-effects that appear at its cessation and depend on its dose. However, there is a lack of studies about the acute effects of HDST on cardiac function in adult patients. METHODS: We included in this study 30 patients who underwent HDST (intravenously at doses ranging from 250 to 1000 mg) and 30 healthy control subjects with similar demographic and clinical characteristics, between September and December 2016. Echocardiographic measurements were made before and during the first 3 hours after the end of treatment, and results were compared between patients and controls. RESULTS: There was no difference in baseline biochemical and echocardiographic characteristics between the patient and control groups. While left ventricular global longitudinal strain (LVGLS) and strain rate E were higher after treatment, no significant change was observed in conventional echocardiographic variables. CONCLUSIONS: LVGLS, but not conventional echocardiographic variables, showed an increase in cardiac systolic function at the acute phase of HDST.

The effect of dialysis type on left atrial functions in patients with end-stage renal failure: A propensity score-matched analysis.

INTRODUCTION: Despite the widespread use of both hemodialysis (HD) and peritoneal dialysis (PD), there is no study comparing the effects of these dialysis methods on the left atrial (LA) volume and functions. In this study, we investigated the impact of different dialysis methods on the LA volume and function in the patients exposed to chronic pressure overload and volume overload. METHOD: This study was carried out on the patients who received dialysis treatment at our healthcare center between March, 2015 and January, 2016. Twenty-eight patients receiving hemodialysis (HD) treatment and 24 patients under PD treatment were enrolled into the study. Patients were divided into 2 groups according to the dialysis therapy, and the atrial volumetric and mechanical functions were investigated. RESULTS: As the basal demographical characteristics of patients in the PD and HD groups were significantly different, 44 patients matched on a 1:1 basis were taken for final analysis (22 HD, 22 PD, and the average age of 42.4 ± 4.8; 73% was male). After propensity score matching analysis, it was determined that left atrial volume index (LAVi) was higher in the HD group while peak LA strain and LA contraction strain were higher in the PD group. Additionally, both strain parameters showed a good negative correlation with LAVi. CONCLUSION: We demonstrated that the left atrial structure and functions were better in the PD group suggesting that PD may be a relatively better option for the preservation and maintenance of the left atrial functions as compared to HD.

A Novel Marker of Inflammation: Azurocidin in Patients with ST Segment Elevation Myocardial Infarction.

(1) To investigate the role of azurocidin, an antimicrobial protein, in patients with ST segment elevation myocardial infarction (STEMI). (2) This single-center prospective observational study included patients with STEMI and healthy age- and sex-matched control subjects. Baseline demographic, clinical and biochemical data were compared between the two groups. Azurocidin levels at baseline were determined using an enzyme-linked immunosorbent assay. Multivariate linear regression analysis with enter method was used to test the association between azurocidin and independent variables, such as the thrombolysis in myocardial infarction (TIMI) score, synergy between percutaneous coronary intervention with TAXUS and cardiac surgery score, global registry of acute coronary events score, Killip class, C-reactive protein (CRP), and creatinine kinase-myocardial band (CK-MB). (3) A total of 76 patients with STEMI and 30 healthy control subjects were enrolled in the study. Mean ± SD azurocidin levels were significantly higher in patients compared with healthy controls (18.07 ± 13.99 versus 10.09 ± 5.29 ng/mL, respectively). In a receiver-operating characteristic curve analysis, an azurocidin cut-off level of >11.46 ng/mL had 74% sensitivity and 58% specificity in predicting myocardial infarction. Azurocidin levels had a positive correlation with TIMI score (r = 0.651). In multivariate linear regression analysis, the TIMI score was an independent predictor of the azurocidin level. (4) Azurocidin is an infection marker that may be important in patients with STEMI.

Comparison of the three conventional methods for the postoperative atrial fibrillation prediction.

INTRODUCTION: Although various risk factors have been defined for the development of postoperative atrial fibrillation (PAF), these parameters have not been adequately verified and validated. We investigated the atrial fibrillation detection capabilities of echocardiographic parameters in PAF developing and the determination of predictive values for clinical use. METHOD: We enrolled 60 consecutive patients with 234 lesions who underwent CABG surgery. All patients underwent preoperative echocardiographic evaluation. Patients were divided into two groups according to PAF development status. RESULTS: The mean age of the patients was 67, and 73% were male and PAF occurred in 19 patients. In univariate analysis, left atrial volume index (LAVi), left ventricular global strain (LVGS) and ejection fraction were associated with PAF development. Parameters which were significant in univariate analysis were included in a logistic regression model to determine the independent predictors of PAF. LAVi was found to be an independent predictor of PAF. CONCLUSION: Although several parameters have been defined for PAF development, LAVi is more advantageous than the other conventional methods in clinical decision making.

Massive pulmonary embolism mimicking electrocardiographic pattern of Brugada syndrome.

Brugada syndrome is an inherited heart disease without structural abnormalities that is thought to arise as a result of accelerated inactivation of Na channels and predominance of transient outward K current to generate a voltage gradient in the right ventricular layers. Brugada syndrome occurs in patients with structurally normal heart and predisposes patients to malignant ventricular arrhythmias. Acute pulmonary embolism has been associated with a variety of electrocardiograms,and rarely, it may mimic electrocardiographic pattern of Brugada syndrome and this condition was defined as Brugada phenocopy.

Relationship between platelet/hemoglobin and radial thrombus in patients with coronary angiography via radial access.

Aim: To predict the development of radial artery thrombus (RAT) in patients with radial approach coronary angiography of platelet-to-hemoglobin ratio (PHR). Materials & methods: This study was designed to evaluate the relationship between RAT and PHR. A total of 1156 patients who had coronary angiography via the transradial approach between 2021 and 2022 in the authors' center were included in the study. Results: Radial thrombus was detected in 52 (4.5%) patients. PHR was higher in the group with thrombus and was statistically significant. In the regression model, PHR was an independent predictor of the development of radial thrombus (p = 0.007). Conclusion: High PHR may be an independent predictor of the development of radial thrombus.

Evaluation of various blood biomarkers associated with the outcomes of patients with COVID­19 treated in intensive care units.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the resulting coronavirus disease 2019 (COVID-19) represented a global public health crisis and the most significant pandemic in modern times. Transmission characteristics, and the lack of effective antiviral treatment protocol and protective vaccines, pushed healthcare systems, particularly intensive care units (ICUs), to their limits and led to extreme quarantine measures to control the pandemic. It was evident from an early stage that patient stratification approaches needed to be developed to better predict disease progression. In the present study, the predictive value of clinical and blood biomarkers for the outcomes of patients with COVID-19 hospitalized in the ICU were investigated, taking age and sex into consideration. The present study analyzed blood samples from 3,050 patients with COVID-19 hospitalized in the ICU. The analysis revealed that the levels of procalcitonin, N-terminal pro-B-type natriuretic peptide, D-dimer, ferritin, liver enzymes, C-reactive protein and lactate dehydrogenase were increased and were associated with disease progression, resulting in a prolonged hospitalization period and severe COVID-19 related complications. Additionally, significant age and sex disparities among these biomarkers were documented and discussed in specific cases. On the whole, the results of the present study suggest a potential association of the demographic characteristics and blood biomarkers with prolonged hospitalization in the ICU and the mortality of patients with COVID-19.

CVD22: Explainable artificial intelligence determination of the relationship of troponin to D-Dimer, mortality, and CK-MB in COVID-19 patients.

BACKGROUND AND PURPOSE: COVID-19, which emerged in Wuhan (China), is one of the deadliest and fastest-spreading pandemics as of the end of 2019. According to the World Health Organization (WHO), there are more than 100 million infectious cases worldwide. Therefore, research models are crucial for managing the pandemic scenario. However, because the behavior of this epidemic is so complex and difficult to understand, an effective model must not only produce accurate predictive results but must also have a clear explanation that enables human experts to act proactively. For this reason, an innovative study has been planned to diagnose Troponin levels in the COVID-19 process with explainable white box algorithms to reach a clear explanation. METHODS: Using the pandemic data provided by Erzurum Training and Research Hospital (decision number: 2022/13-145), an interpretable explanation of Troponin data was provided in the COVID-19 process with SHApley Additive exPlanations (SHAP) algorithms. Five machine learning (ML) algorithms were developed. Model performances were determined based on training, test accuracies, precision, F1-score, recall, and AUC (Area Under the Curve) values. Feature importance was estimated according to Shapley values by applying the SHApley Additive exPlanations (SHAP) method to the model with high accuracy. The model created with Streamlit v.3.9 was integrated into the interface with the name CVD22. RESULTS: Among the five-machine learning (ML) models created with pandemic data, the best model was selected with the values of 1.0, 0.83, 0.86, 0.83, 0.80, and 0.91 in train and test accuracy, precision, F1-score, recall, and AUC values, respectively. As a result of feature selection and SHApley Additive exPlanations (SHAP) algorithms applied to the XGBoost model, it was determined that DDimer mean, mortality, CKMB (creatine kinase myocardial band), and Glucose were the features with the highest importance over the model estimation. CONCLUSIONS: Recent advances in new explainable artificial intelligence (XAI) models have successfully made it possible to predict the future using large historical datasets. Therefore, throughout the ongoing pandemic, CVD22 (https://cvd22covid.streamlitapp.com/) can be used as a guide to help authorities or medical professionals make the best decisions quickly.

Cardiac Parameters Better Predict ICU Admission and Short-Term Mortality in Hospitalized Patients With COVID-19.

Background COVID-19 is a multisystemic disease that affects many organs, and the use of some parameters is recommended both during hospitalization and follow-up. In this study, we investigated the relationship between blood (liver and kidney function tests, lactate, and D-dimer), infection (C-reactive protein (CRP), lymphocyte count, ferritin, and albumin), and cardiac (creatine kinase-myocardial band (CK-MB), troponin, and brain natriuretic peptide (BNP)) parameters with intensive care unit (ICU) admission and mortality. Materials and methods Patients hospitalized in Erzurum City Hospital with the diagnosis of COVID-19 between April 2020 and November 2022 were included in this retrospective study. The patient's files and electronic media records were retrospectively reviewed, and the patient's anamnesis, physical examination, clinical findings, biochemical parameters, and treatment methods were recorded. The ICU needs of the patients and the treatment processes in intensive care were found in the in-hospital records. The hospital records and six-month mortality data were obtained retrospectively with the necessary permissions. Thus, blood parameters and their relation to each other in terms of prognosis were evaluated in determining the six-month mortality rates of the patients and estimating the need for ICU. Results A total of 5100 patients were included in the study. The mean age of patients with mortality was 74.2 ± 11.2 and that without mortality was 59.9 ± 15.7 (p < 0.001). In the mortality (+) group, 61.5% of patients were male, and in the mortality (-) group, 47.4% of the patients were male (p < 0.001). The mean age of patients with ICU admission was 69.6 ± 13.6 and without ICU admission was 60.3 ± 15.9 years (p < 0.001). In the ICU admission (+) group, 60.5% of patients were male; and in the ICU admission (-) group, 47.2% of patients were male (p < 0.001). Death and ICU admission were observed more frequently in elderly and male patients (p < 0.001 for both mortality and ICU admission). Blood parameters were evaluated both in the mortality and ICU groups, and organ function tests, blood count parameters, inflammatory markers, and cardiac parameters were significantly associated with poor outcomes. Cox regression analysis showed that lactate, albumin, Ln(troponin), and Ln(BNP) were independent predictors of mortality and ICU admission. Receiver operating characteristics (ROC) curve analysis showed that Ln(troponin) and Ln(BNP) levels predicted the development of mortality and ICU admission better than other parameters. Discussion COVID-19 can cause problems in different systems as a result of an inflammatory response, secreted cytokines, hypercoagulability, and direct tissue damage. When treating patients, a more appropriate approach is to evaluate different parameters together rather than focusing on a single parameter and deciding accordingly. However, evaluating alterations in many parameters in a disease that affects many systems is difficult and increases the risk of mistakes. Although each blood parameter separately is important, it was observed that the cardiac parameters troponin I and BNP have better predictive values than others in predicting the course and prognosis of COVID-19. Conclusion Blood parameters are used in COVID-19 diagnosis, treatment, and follow-up. Although it is not primarily a cardiac disease, cardiac markers can provide better results in showing the course and prognosis of COVID-19.

Role of Systemic Immune-Inflammatory Index in Predicting the Development of In-Hospital Malignant Ventricular Arrhythmia in Patients With ST-Elevated Myocardial Infarction.

Many complications can be observed after ST-elevation myocardial infarction (STEMI). The systemic immune-inflammatory index (SII) is a sensitive indicator of the inflammatory state, and this parameter may also be associated with cardiovascular diseases. In this study, we investigated the relationship between malignant ventricular arrhythmias (MVA) development and SII in STEMI patients. A total of 1708 STEMI patients were included in the study. Propensity score matching (PSM) analysis was performed. Patients were divided into 2 groups according to the development of MVA, and predictors of MVA development were investigated. After the PSM analysis, the mean age of 158 patients was 61.6 years, and 68.4% were male. In the univariate analysis, neutrophil count, SII, C-reactive protein (CRP), albumin, and CRP/albumin ratio (CAR) were associated with the development of MVA; while in the regression analysis, CAR and SII was found to be independent predictors of the development of MVA. In this study, we demonstrated that SII is a better independent predictor than other inflammatory parameters for predicting the development of MVA. This index may be useful in clinical use.