Predictive value of complete blood count parameters for 30-day mortality risk in acute myocardial infarction patients

To investigate the predictive value of complete blood count (CBC) parameters for 30-day mortality risk in patients with acute myocardial infarction (AMI) and to develop a clinical prediction model. This retrospective cohort study enrolled 189 AMI patients between January 2020 and December 2024, categorizing them into survival ( n = 144) and non-survival ( n = 45) groups based on 30-day outcomes. Baseline data and CBC parameters were analyzed. Univariate and multivariate logistic regression identified independent risk factors, followed by the construction of a nomogram model. Model performance was evaluated using receiver operating characteristic (ROC) curves and bootstrap validation. The results showed that non-survivors were significantly older ( p < 0.001), higher mean platelet volume (MPV) ( p = 0.012) and had a significantly lower hemoglobin-to-red cell distribution width ratio (HRR) ( p < 0.001). Multivariate analysis confirmed age (Odds Ratio (OR) = 1.054, 95% CI: 1.020–1.088, p = 0.002), MPV (OR = 1.325, 95% CI: 1.000–1.755, P = 0.049), and HRR (OR = 0.775, 95% CI: 0.662–0.906, P = 0.001) as independent risk factors after adjusting for other CBC parameters. The nomogram model achieved an area under the curve (AUC) of 0.775 (95% CI: 0.696–0.854) and a concordance index (C-index) of 0.768. In conclusion, age, MPV, and HRR are independent predictors of 30-day mortality in AMI. The nomogram integrating these three factors demonstrates acceptable predictive performance and outperforms any single parameter, offering a practical tool for early risk stratification.