Inflammation, Infarct Size and 10-Year Mortality in STEMI Patients Stratified by the ORBI Risk Score: A DANAMI-3 Sub-study

doi:10.1093/ehjacc/zuag126

Coronary disease & ACSSecondary analysis

Inflammation, Infarct Size and 10-Year Mortality in ST-elevation Myocardial Infarction (STEMI) Patients Stratified by the ORBI Risk Score: A DANAMI-3 Sub-study

Eur Heart J Acute Cardiovasc CarePublished 3 Oct 2026

DANAMI-3 sub-study

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Authors' conclusion

The ORBI Risk Score identifies STEMI patients with more inflammation, larger infarcts and higher mortality, especially in the first year. Beyond the first year the association was largely explained by age. Whether anti-inflammatory treatment benefits these patients is a question for randomised trials.

Study context

Population: STEMI patients without cardiogenic shock treated with primary percutaneous coronary intervention (PCI)STEMI patients without cardiogenic shock · high risk (ORBI ≥8) 273 · low risk 1,301
Participants: 1,574 patients

Comparison: High vs low ORBI risk
high riskn = 273
low riskn = 1,301reference

Primary result

As reported in the abstract

Peak C-reactive protein (CRP) · within 72 hours of PCI

high risk72mg/L

low risk11mg/L

Further findings

Leukocyte count

high risk12.8 × 109/L

low risk10.4 × 109/L

MR-proADM · admission

high risk0.73 nmol/L

low risk0.62 nmol/L

Final infarct size

high risk15.7% of left ventricular mass

low risk10.1% of left ventricular mass

Outcome	high risk	low risk	Lower with high risk ←→ Higher with high risk	Hazard ratio
All-cause mortality · 10 years · unadjusted	41%	20%		2.56 (95% CI 2.05–3.20)
All-cause mortality · 10 years · adjusted				1.47 (CI 1.16–1.85)
			0.20.5125Hazard ratio (log scale)

Outcome	high risk	low risk	hazard ratio
NLR	6.2	3.5
All-cause mortality · 10 years · adjusted, within 30 days			4.79
All-cause mortality · 10 years · adjusted, after the first year			1.27

Leukocyte count: p < 0.001
Neutrophil-to-lymphocyte ratio (NLR): p < 0.001
Mid-regional pro-adrenomedullin (MR-proADM): p < 0.001
All-cause mortality: adjusted for age, sex, comorbidity, kidney function and randomised allocation

Discrimination of 10-year mortality

area under the curve, ORBI score: 0.67
area under the curve, age alone: 0.79

Original publication

Inflammation, Infarct Size and 10-Year Mortality in STEMI Patients Stratified by the ORBI Risk Score: A DANAMI-3 Sub-study. Eur Heart J Acute Cardiovasc Care. Published 3 October 2026. doi:10.1093/ehjacc/zuag126

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Summarised from the published abstract; every number is checked against it