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Association of Systemic Immune Inflammation Index with All-Cause, Cardiovascular Disease, and Cancer-Related
Shengjue Xiao1, Zhenwei Wang1, Ronghua Zuo2
1Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, People's Republic of China.
Insights
The systemic immune inflammation (SII) index shows a U-shaped relationship with mortality from all causes, cardiovascular disease (CVD), and cancer in CVD patients. This indicates that both very low and very high SII index levels are associated with increased mortality risk.
Area of Science:
- Cardiovascular Medicine
- Immunology
- Public Health
Background:
- The systemic immune inflammation (SII) index, a marker of systemic inflammation, has been explored for its prognostic value in various diseases.
- Understanding the association between SII index and mortality outcomes in patients with cardiovascular disease (CVD) is crucial for risk stratification and management.
Purpose of the Study:
- To investigate the relationship between the SII index and all-cause, CVD-specific, and cancer-related mortality in a US population with diagnosed CVD.
- To explore the nature of this association, including potential non-linear relationships.
Main Methods:
- Utilized data from the National Health and Nutrition Examination Survey (1999-2018).
- Employed restricted cubic splines (RCS) and Cox proportional hazard models to analyze the association between SII index and mortality outcomes.
- Conducted subgroup analyses to examine associations in specific CVD subtypes.
Main Results:
- A U-shaped correlation was observed between the SII index and all-cause, CVD, and cancer-related mortality in patients with CVD.
- Compared to the lowest quartile, higher quartiles of SII index showed increased hazard ratios for all-cause, CVD, and cancer mortality.
- Specific CVD subtypes like coronary heart disease (CHD), angina, and myocardial infarction exhibited a U-shaped relationship, while congestive heart failure (CHF) and stroke showed a positive linear correlation with CVD mortality at higher SII index levels.
Conclusions:
- The SII index demonstrates a U-shaped association with all-cause, CVD, and cancer-related mortality in the general US population with CVD.
- This finding suggests that both low and high levels of systemic immune inflammation may be detrimental for patients with cardiovascular disease.
Objective:
Our research was designed to investigate the relationship between systemic immune inflammation (SII) index and all-cause, cardiovascular disease (CVD), and cancer-related mortality in patients with CVD.
Methods:
We used the National Health and Nutrition Examination Survey data from 1999 to 2018 to conduct this study. The association between SII index and all-cause, CVD, and cancer-related mortality in patients with CVD was examined using restricted cubic splines (RCS), Cox proportional hazard models, and subgroup analysis, respectively. CVD was defined as a composite of five outcomes of CVD, including coronary heart disease (CHD), congestive heart failure (CHF), angina pectoris, myocardial infarction, and stroke. Additionally, the link between SII index and all-cause, CVD, and cancer-related mortality in patients with a composite of five outcomes of CVD was also explored.
Results:
In total, 5329 participants were included. The RCS also showed a U-curve correlation between SII index and the all-cause, CVD, and cancer-related mortality in patients with CVD. As compared with the individuals with lowest quartile of SII index, hazard ratios with 95% confidence intervals for all-cause, CVD, and cancer-related mortality across the quartiles were (1.202 (0.981, 1.474), 1.184 (0.967, 1.450), and 1.365 (1.115, 1.672)), (1.116 (0.815, 1.527), 1.017 (0.740, 1.398), and 1.220 (0.891, 1.670)), and (1.202 (0.981, 1.474), 1.184 (0.967, 1.450), and 1.365 (1.115, 1.672)), respectively, in the full-adjusted model. The SII index also had a U-shaped relationship with all-cause, CVD, and cancer-related mortality in patients with CHD, angina, and myocardial infarction. Additionally, the U-shaped relationship between SII index and all-cause, and cancer-related mortality also exists in CHF, and stroke. However, there was a positive linear correlation between SII index and CVD mortality in patients with CHF, and stroke.
Conclusion:
In the United States general population, the correlation between SII index and all-cause, CVD, and cancer-related mortality showed a U-shaped curve in patients with CVD.
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