ArticleEuropean journal of medical research2025
Association between the Endothelial Activation and Stress Index (EASIX) and all-cause and cardiovascular mortality in patients with diabetes and prediabetes.
Article in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Relationship between endothelial activation and stress index and radial artery occlusion in patients undergoing radial access percutaneous coronary intervention.Journal of cardiothoracic surgery · 2026Article
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- Endothelial Activation and Stress Index (EASIX) in migraine: association with disease subtypes and clinical characteristics.BMC neurology · 2026Article
- Article
- Endothelial activation and stress index links to cardiovascular disease in postmenopausal women mediated by arterial stiffness: A cross-sectional study of National Health and Nutrition Examination Survey 1999-2018.The Journal of international medical research · 2026Article
- EASIX Score as an Independent Prognostic Marker in De Novo Metastatic Pancreatic Cancer.Medicina (Kaunas, Lithuania) · 2026Article
- Admission EASIX Score Predicts Coronary No-Reflow and In-Hospital Mortality in STEMI Patients Undergoing Primary PCI.Journal of clinical medicine · 2026Article
- Endothelial Activation and Stress Index (EASIX) Predicts In-Hospital Mortality in Acute Decompensated Heart Failure with Reduced Ejection Fraction.Diagnostics (Basel, Switzerland) · 2026Article
- Relationship of endothelial activation and stress index on concurrent acute kidney injury in patients with heart failure during intensive care unit: a competing risk model analysis.BMC cardiovascular disorders · 2025Observational
- Endothelial Dysfunction and Erectile Dysfunction: Evidence From EASIX Score in NHANES 2001-2004.American journal of men's healthArticle
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Abstract
backgroundVascular endothelial impairment is crucial in diabetes and its cardiovascular complications, but clinically applicable endothelial function markers remain limited. We investigated the Endothelial Activation and Stress Index (EASIX), a novel biomarker calculated from lactate dehydrogenase, creatinine, and platelet count, for predicting mortality in diabetes and prediabetes populations.
methodsThe study analyzed data from 20,285 participants with diabetes or prediabetes enrolled in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Mortality outcomes were tracked through the National Death Index until December 2019. EASIX was calculated as: lactate dehydrogenase (U/L) × creatinine (mg/dL)/platelet count (10
resultsDuring a median follow-up of 90.2 months, 3,432 deaths occurred, including 1,128 cardiovascular-related deaths. Higher EASIX values were significantly associated with increased risks of all-cause and cardiovascular mortality (P for trend < 0.0001). In the fully adjusted model, the highest EASIX quartile (Q4) demonstrated significantly higher risks as compared to the lowest quartile (Q1): all-cause mortality (HR: 1.50, 95% CI 1.33-1.69) and cardiovascular mortality (HR: 1.72, 95% CI 1.38-2.14). Nonlinear relationships were observed between EASIX and mortality outcomes (P for nonlinearity < 0.001). While EASIX predicted outcomes in both populations, diabetic patients showed a more pronounced effect. Subgroup analyses revealed more significant associations in females (HR: 1.36, 95% CI 1.28-1.44) compared to males (HR: 1.18, 95% CI 1.13-1.22), and the association was modified by hypertension status (P for interaction = 0.002).
conclusionEASIX emerges as an independent predictor of all-cause and cardiovascular mortality in diabetes and prediabetes patients. Its accessibility makes it a practical tool for identifying patients requiring intensive monitoring and intervention. The stronger associations in specific subgroups, particularly among diabetic patients and females, underscore the need for targeted approaches.
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