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Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease

Ya-Ling Yang1,2,3,4, Cheng-Hsueh Wu1,2, Pai-Feng Hsu1,2,3,5

  • 1Division of Cardiology, Department of Medicine, Healthcare and Management Center, Taipei, Taiwan.

European Journal of Clinical Investigation
|April 16, 2020
PubMed

Insights

The systemic immune-inflammation index (SII) predicts major cardiovascular events in coronary artery disease patients post-intervention. Higher SII scores indicate an increased risk of cardiac events, outperforming traditional risk factors.

Area of Science:

  • Cardiology
  • Inflammation Research
  • Biomarker Discovery

Background:

  • Coronary artery disease (CAD) poses significant cardiovascular risks.
  • Novel biomarkers are needed for improved risk prediction in CAD patients.
  • The systemic immune-inflammation index (SII), calculated as platelet × neutrophil/lymphocyte ratio, is a potential prognostic marker.

Purpose of the Study:

  • To evaluate the predictive value of the systemic immune-inflammation index (SII) for major cardiovascular events (MACE) in patients with coronary artery disease (CAD) following percutaneous coronary intervention (PCI).
  • To compare the predictive performance of SII against traditional risk factors in this patient population.

Main Methods:

  • A cohort of 5602 CAD patients undergoing PCI was analyzed.
  • Patients were stratified into high and low SII groups based on a validated cut-off point (694.3 × 10⁹).
  • Primary outcomes included nonfatal myocardial infarction (MI), nonfatal stroke, and cardiac death; secondary outcomes included MACE plus heart failure hospitalization.

Main Results:

  • A higher SII score (≥694.3) was independently associated with increased risks of cardiac death, nonfatal MI, nonfatal stroke, MACE, and total major events.
  • The SII significantly improved the risk stratification of MI, cardiac death, heart failure, and MACE compared to conventional risk factors.
  • Improvements in risk prediction were evidenced by significant increases in C-index, Net Reclassification Improvement (NRI), and Integrated Discrimination Improvement (IDI).

Conclusions:

  • The systemic immune-inflammation index (SII) serves as a valuable and independent predictor of major cardiovascular events in CAD patients after PCI.
  • SII demonstrates superior predictive capability for cardiovascular events compared to traditional risk factors in this cohort.
  • The findings support the integration of SII into risk assessment protocols for CAD patients undergoing intervention.
Abstract

Keywords:
coronary artery diseaseinflammationpercutaneous coronary intervention

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