The prognostic value of expiratory carbon monoxide level for outcome prediction after myocardial infarction
Authors' conclusion
This is the first study to demonstrate that elevated expiratory CO levels upon admission are independently associated with an increased risk of 1-year all-cause mortality, 1-year MACEs, and in-hospital MAEs in patients hospitalized for MI.
Study context
- Population
- Consecutive patients hospitalised for myocardial infarction (MI) (64 ± 13 years; 75% males; 33% active smokers; 43% STEMI)
- Participants
- 717 patients
- Exposure
- Elevated vs non-elevated expiratory CO levels on admission
- Elevated COn = 79
- Outcome
- All-cause death
- Follow-up
- 1 year
Methodological detailsmulticentre, 39 centres, consecutive patients
- Multicentre
- 39 centres
- Consecutive patients
Main finding
As reported in the abstract
1-year all-cause mortality
Elevated CO vs No elevated COOdds ratio (95% CI)
Adjusted for comorbidities
3.6(1.7–7.5)
Adjusted for clinical parameters of in-hospital severity
4.5(2.3–8.8)
Adjusted for respiratory parameters
6.3(3.1–12.8)
Observational data: associations, not effects.
Secondary outcomes
1-year MACE (CV death and recurrent MI) and in-hospital major adverse events (death, severe ventricular arrhythmia, cardiogenic shock, need for mechanical ventilation)
- Elevated CO independently associated with a significant increase in 1-year MACE and in-hospital major adverse events
Machine learning analysis
- CO level one of the most important predictors of adverse events, compared with other known prognosticators
Original publication
The prognostic value of expiratory carbon monoxide level for outcome prediction after myocardial infarction. Eur J Prev Cardiol. Published 7 October 2025. doi:10.
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