The Predictive Role of a Novel Risk Index in Patients Undergoing Carotid Artery Stenting: Systemic
Muhammed Keskin1, Lütfi Öcal2, Sinan Cerşit2
1Cardiology, Bahcesehir University, Faculty of Medicine, Istanbul, Turkey.
Insights
The Systemic Immune-Inflammation Index (SII) predicts outcomes in patients undergoing carotid artery stenting (CAS). Higher SII levels are linked to increased risks of stroke, heart attack, and death, highlighting its prognostic value in cardiovascular care.
Area of Science:
- Cardiology
- Vascular Surgery
- Inflammation Research
Background:
- Inflammatory mechanisms are crucial in atherosclerosis and stroke.
- Peripheral blood markers correlate with carotid artery stenosis severity and outcomes.
- The prognostic role of blood cell counts and ratios in carotid artery stenting (CAS) outcomes requires further investigation.
- Systemic Immune-Inflammation Index (SII) is established in oncology but less studied in cardiovascular disorders.
Purpose of the Study:
- To evaluate the effect of the novel Systemic Immune-Inflammation Index (SII) on in-hospital and long-term outcomes in patients undergoing CAS.
- To assess the prognostic value of SII in predicting adverse events after CAS.
Main Methods:
- A total of 732 patients undergoing CAS for carotid artery stenosis were enrolled.
- SII was calculated as neutrophil-to-lymphocyte ratio × total platelet count.
- Patients were stratified into three tertiles (T1, T2, T3) based on SII levels.
- In-hospital and 5-year outcomes were compared across SII tertiles.
Main Results:
- High SII levels (T3) were associated with significantly higher rates of major stroke, ipsilateral stroke, myocardial infarction, death, and major adverse cardiovascular events (MACE) during hospitalization.
- Higher SII levels (T3) also correlated with increased risks of ipsilateral stroke, major stroke, transient ischemic attack, death, and MACE in long-term follow-up.
- Five-year Kaplan-Meier survival rates were 97.5% for T1, 96.7% for T2, and 86.0% for T3.
- Regression analyses confirmed that high SII was an independent predictor of MACE and mortality.
Conclusions:
- The Systemic Immune-Inflammation Index (SII) is independently associated with adverse in-hospital and long-term clinical outcomes in patients undergoing CAS.
- SII provides a valuable, easily accessible assessment of immune and inflammation status for risk stratification in CAS patients.
Background:
Inflammatory mechanisms play an important role in both atherosclerosis and stroke. There are several inflammatory peripheral blood count markers associated with carotid artery stenosis degree, symptomatic carotid artery lesions and carotid artery stent restenosis that reported in previous studies. However, the prognostic role of the blood cell counts and their ratios in predicting in-hospital and long-term outcomes in patients undergoing carotid artery stenting (CAS) has not been comprehensively investigated. Systemic immune-inflammation index (SII) proved its' efficiency in patients with solid tumors and its' role was rarely examined in cardiovascular disorders and stroke. The current study evaluated the effect of this novel risk index on in-hospital and long-term outcomes in a large patient population who underwent CAS.
Method:
A total of 732 patients with carotid artery stenosis who underwent CAS were enrolled to the study. SII was calculated using the following formula: neutrophil-to-lymphocyte ratio × total platelet count in the peripheral blood (per mm3) and the patients were stratified accordingly: T1, T2 and T3. In-hospital and 5-year outcomes were compared between the tertiles of SII.
Results:
During the hospitalization, major stroke, ipsilateral stoke, myocardial infarction, death and major adverse cardiovascular events (MACE) rates were significantly higher in high SII level (T3) compared to SII levels (T1 and 2). In long-term outcomes, ipsilateral stroke, major stroke, transient ischemic attack, death, and MACE were significantly higher in the patients with higher SII level (T3). The 5-year Kaplan-Meier overall survival for T1, T2, and T3 were 97.5%, 96.7% and 86.0% respectively. In-hospital and 5-year regression analyses demonstrated that high SII was independently associated with MACE and mortality.
Conclusion:
SII was independently associated with in-hospital and long-term clinical outcomes in patients undergoing CAS. Immune and inflammation status, as assessed easily and quickly using SII, has a good discriminative value in these patients.
Related Concept Videos
01:27Psychoneuroimmunology: Cardiovascular Disease
A key area of focus in PNI is the relationship between stress and coronary...
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:30Coronary Artery Disease I: Introduction
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:30Acute Coronary Syndrome III: Diagnostic Studies