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Association between pan-immune-inflammation value and no-reflow in patients with ST elevation myocardial infarction

Adil Bayramoğlu1, Şıho Hidayet1

  • 1Department of Cardiology, Inonu University, Malatya, Turkey.

Scandinavian Journal of Clinical and Laboratory Investigation
|July 27, 2023
PubMed

Insights

The novel pan-immune-inflammation value (PIV) effectively predicts the no-reflow phenomenon in ST-elevation myocardial infarction patients. Higher PIV levels indicate a greater risk of no-reflow, outperforming the systemic immune-inflammation index (SII).

Area of Science:

  • Cardiovascular Medicine
  • Inflammation and Immunology
  • Biomarker Discovery

Background:

  • No-reflow is a critical complication in ST-segment elevation myocardial infarction (STEMI) associated with poor patient prognosis.
  • Several inflammatory markers, including C-reactive protein and neutrophil-to-lymphocyte ratio, are linked to the no-reflow phenomenon.
  • The systemic immune-inflammation index (SII) has shown predictive value, but novel indices require investigation.

Purpose of the Study:

  • To retrospectively evaluate the relationship between the pan-immune-inflammation value (PIV) and the occurrence of no-reflow in STEMI patients.
  • To determine if PIV can serve as an independent predictor of no-reflow.
  • To compare the predictive performance of PIV against the SII for no-reflow.

Main Methods:

  • A retrospective analysis included 1212 STEMI patients, with 145 experiencing no-reflow.
  • Multivariate logistic regression analysis identified independent predictors of no-reflow.
  • Receiver Operating Characteristic (ROC) curve analysis assessed the diagnostic accuracy of PIV, comparing it with SII.

Main Results:

  • PIV emerged as an independent predictor of no-reflow (OR: 1.025, p < 0.001), alongside baseline ejection fraction, stent length, age, and pain-to-PCI time.
  • The optimal PIV cutoff for predicting no-reflow was ≥889, demonstrating 77.2% sensitivity and 77.5% specificity (AUC: 0.828).
  • PIV exhibited significantly higher predictive power for no-reflow compared to SII (p < 0.001).

Conclusions:

  • Elevated PIV is an independent predictor of no-reflow in STEMI patients.
  • PIV offers superior predictive capability for no-reflow compared to SII.
  • PIV represents a promising novel biomarker for assessing no-reflow risk in STEMI.

Keywords:
Pan-Immune-Inflammation valueST- elevation myocardial infarctionnoreflowpercutaneous coronary ınterventionsystemic immune inflammatory index

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