In 30-day survivors of NSTEMI, composite indices showed no evidence of improved long-term mortality discrimination over a study-specific clinical model and contained no information beyond their measured constituents.
Composite haematological/nutritional indices had modest discrimination for five-year all-cause mortality, and none exceeded CRP alone after multiplicity correction.
Eight composite indices were nominally associated with mortality after adjustment, but none improved the C-index over the clinical model.
Fixed composite indices performed similarly to freely weighted models of their own constituents.
Over a reference model adding CRP and albumin, no estimable composite index showed evidence of association with mortality.
The independent associations of composite indices with mortality may largely reflect information already present in their components, and the findings do not establish equivalence.
This study looked at whether blood-test-based scores that combine several routine measurements (such as inflammation, blood cell counts and nutrition markers) help predict long-term death after a type of heart attack called NSTEMI. Researchers followed 561 patients who survived the first 30 days for a median of about 5.5 years; 94 died during follow-up. Many of the combined scores were statistically linked to death, even after accounting for other factors. However, none of them improved the ability to tell who would die over what a basic clinical model already provided. They also did no better than the individual blood tests they were built from, and simple CRP (an inflammation marker) did at least as well. Even when CRP and albumin were added to the clinical model, the combined scores added nothing detectable. This research suggests that the popular combined blood scores may mostly repeat information already contained in their component tests, rather than offering new prognostic value. The authors caution that small benefits cannot be ruled out and that the study does not prove the scores are equivalent to their components. It was also a single-centre study with a limited number of deaths, so findings should be confirmed in other settings.
Bozbeyoğlu E, Sungur A, Can F, Şimşek B, Genç Albayrak D, Pamuk F, et al.. (2026). Composite Haematological and Nutritional Indices Show No Evidence of Improved Long-Term Mortality Discrimination Beyond Their Own Components in Non-ST-Segment Elevation Myocardial Infarction.. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina62101965