ArticleClinical research in cardiology : official journal of the German Cardiac Society2026
Longitudinal Endothelial Activation and Stress Index (EASIX) trajectories and mortality risk in chronic heart failure.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Endothelial Activation and Stress Index (EASIX) is a routinely available marker of endothelial activation and systemic stress. Although baseline EASIX predicts mortality in chronic heart failure, its long-term longitudinal behavior and prognostic relevance during follow-up remain insufficiently characterized.
aimTo assess whether serial EASIX measurements identify clinically relevant risk trajectories and improve dynamic mortality risk stratification in chronic heart failure.
methodsWe analyzed 1924 patients with chronic heart failure from the Heidelberg chronic heart failure outpatient registry with at least two available EASIX measurements. The main landmark transition analysis included 1789 patients with valid first-to-second transition assignment, follow-up after the second EASIX measurement, and complete covariate data for the adjusted Cox model. Patients were categorized into early EASIX transition groups using the median baseline log2(EASIX) threshold applied to the first and second measurements. Survival analyses were landmarked at the second EASIX measurement. Associations with all-cause mortality were assessed using multivariable Cox regression, patient-specific EASIX slopes derived from linear mixed-effects models, and time-updated Cox models.
resultsIn the full longitudinal cohort, 330 deaths occurred. In the adjusted landmark transition cohort, patients rising from low to high EASIX had markedly increased subsequent mortality compared with stable low patients (adjusted HR 2.33, 95% CI 1.57-3.46; p < 0.001), as did patients with persistently high EASIX (adjusted HR 1.88, 95% CI 1.35-2.62; p < 0.001). Mortality after the second EASIX measurement was lowest in stable low patients and highest in patients rising to high or remaining persistently high. Each 0.10 log2(EASIX) units/year increase in EASIX slope was associated with higher mortality risk (HR 1.43, 95% CI 1.22-1.67; p < 0.001), and time-updated log2(EASIX) remained independently prognostic.
conclusionsSerial EASIX assessment captures dynamic systemic risk in chronic heart failure. Rising or persistently elevated EASIX identifies patients at increased mortality risk and may provide a practical, low-cost tool for longitudinal risk stratification.
Indexed as
Identifiers
42545493What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.