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Prognostic value of systemic immune-inflammation index in CAD patients: Systematic review and meta-analyses

Zehao Zhao1, Xiaoming Zhang1, Tienan Sun1

  • 1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

European Journal of Clinical Investigation
|September 30, 2023
PubMed

Insights

The Systemic Immune-Inflammation Index (SII) predicts adverse cardiovascular events in coronary artery disease (CAD) patients. Higher SII levels are linked to increased risks of major adverse cardiovascular events, death, and stroke.

Area of Science:

  • Cardiology
  • Inflammation markers
  • Prognostic biomarkers

Background:

  • The Systemic Immune-Inflammation Index (SII), derived from neutrophil, platelet, and lymphocyte counts, is a novel inflammatory marker.
  • Observational studies suggest SII has prognostic value in coronary artery disease (CAD).
  • This study aimed to provide robust evidence on the association between SII and adverse outcomes in CAD patients.

Approach:

  • A comprehensive literature search was conducted across PubMed, Web of Science, Embase, Ovid, and Scopus.
  • Relevant studies investigating the prognostic value of SII in CAD patients were included.
  • Hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled using fixed- or random-effect models, with sensitivity and subgroup analyses performed.

Key Points:

  • Nine studies with 15,832 participants were included in the meta-analysis.
  • High SII was significantly associated with major adverse cardiovascular events in CAD patients (HR: 2.36 [1.67, 3.33]).
  • This association remained robust after addressing heterogeneity and publication bias (HR: 1.67 [1.32, 2.12]), and SII also predicted all-cause death, cardiovascular death, myocardial infarction, and stroke.

Conclusions:

  • Elevated Systemic Immune-Inflammation Index (SII) levels serve as a significant prognostic indicator for adverse outcomes in patients with coronary artery disease.
  • The findings support the clinical utility of SII in risk stratification and management of CAD.
Abstract

Keywords:
coronary artery diseaseinflammationmeta-analysisprognosissystemic immune-inflammation index

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