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The Complex Inflammatory and Nutritional Indices to Predict Prognostic Risk for Patients With Acute Coronary Syndrome
Ge Song1, Xinchen Wang1, Chen Wei1
1Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, China.
Insights
The systemic inflammatory response index (SIRI), combined with HDL-C and LDL-C levels, can predict major adverse cardiovascular events (MACEs) in acute coronary syndrome (ACS) patients post-PCI. Higher SIRI values indicate increased MACE risk, offering prognostic insights.
Area of Science:
- Cardiology
- Biomarkers
- Inflammation
Background:
- Acute coronary syndrome (ACS) poses a significant cardiovascular risk.
- Percutaneous coronary intervention (PCI) is a common treatment for ACS.
- Predictive markers for major adverse cardiovascular events (MACEs) in ACS patients undergoing PCI are crucial for risk stratification.
Purpose of the Study:
- To evaluate the prognostic value of the systemic inflammatory response index (SIRI) in relation to high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels.
- To determine the association of SIRI, SIRI/HDL-C ratio, and SIRI×LDL-C product with MACEs in patients with ACS undergoing PCI.
Main Methods:
- A cohort of 1377 patients with ACS who underwent PCI between January 2016 and December 2018 was analyzed.
- Patients were categorized into MACEs (n=60) and non-MACEs (n=1317) groups.
- Statistical analyses included Kaplan-Meier curves, Cox proportional hazards models, and restricted cubic spline models.
Main Results:
- Significant differences were observed between MACEs and non-MACEs groups regarding age, history of heart failure, myocardial infarction, cardiogenic shock, left ventricular ejection fraction, and specific SIRI-related indices (SIRI ≥ 2.848, SIRI/HDL-C ≥ 1.977, SIRI×LDL-C ≥ 4.609).
- Higher SIRI levels were associated with lower cumulative survival.
- SIRI ≥ 2.848, SIRI/HDL-C ≥ 1.977, and SIRI×LDL-C ≥ 4.609 were identified as independent risk factors for MACEs in ACS patients undergoing PCI.
Conclusions:
- Elevated SIRI levels, particularly when combined with specific HDL-C and LDL-C thresholds, serve as independent prognostic risk factors in patients with ACS undergoing PCI.
- These SIRI-based indices may offer valuable tools for assessing long-term prognosis in this patient population.
Purpose:
To investigate the role of the systemic inflammatory response index (SIRI) and high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels in predicting the risk of major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).
Patients And Methods:
Overall, 1377 patients with ACS who underwent PCI between January 2016 and December 2018 were consecutively enrolled. The patients were divided into MACEs (n = 60) and non-MACEs (n = 1317) groups. The study endpoints were MACEs, including cardiac-related mortality and rehospitalization for severe heart failure (HF), myocardial infarction (MI), and in-stent restenosis.
Results:
Both groups showed significant differences in the patients with age > 65 years, history of HF, acute MI, cardiogenic shock, left ventricular ejection fraction < 40%, SIRI ≥ 2.848, SIRI/HDL-C ≥ 1.977, and SIRI × LDL-C ≥ 4.609. The Kaplan-Meier curve showed that the low SIRI group had higher cumulative survival than the high SIRI group. Additionally, the univariate and multivariate Cox proportional hazards model demonstrated that SIRI ≥ 2.848, SIRI/HDL-C ≥ 1.977, and SIRI × LDL-C ≥ 4.609 were independent risk factors for patients with ACS undergoing PCI. Restricted cubic spline models were generated to visualize the relationship between SIRI, SIRI/HDL-C, and SIRI × LDL-C and the prognostic risk.
Conclusion:
SIRI ≥ 2.848, SIRI/HDL-C ≥ 1.977, and SIRI × LDL-C ≥ 4.609 were all independent prognostic risk factors in patients with ACS undergoing PCI, which may be useful markers for assessment for long prognosis.
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