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Predictive value of cumulative SII for MACE in STEMI patients after PCI

Weifeng Zhang1, Haiyan Jia1, Xingzhou Zhao1

  • 1Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, China.

Medicine
|March 28, 2025
PubMed

Insights

Long-term exposure to the systemic immune-inflammation index (SII) increases major adverse cardiovascular events (MACE) risk in myocardial infarction patients. Late elevations in SII significantly heighten MACE risk, emphasizing the need for sustained inflammation control post-procedure.

Area of Science:

  • Cardiology
  • Immunology
  • Prognostic Biomarkers

Background:

  • The systemic immune-inflammation index (SII) is a recognized prognostic marker across various diseases.
  • Limited evidence exists on the association between SII and long-term outcomes in myocardial infarction (MI) patients.
  • Acute ST-elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI) require robust prognostic tools.

Purpose of the Study:

  • To investigate the relationship between cumulative exposure to SII and its time-course dynamics with major adverse cardiovascular events (MACE) in STEMI patients post-PCI.
  • To assess the predictive value of SII for MACE in this patient cohort.

Main Methods:

  • A cohort of 480 STEMI patients undergoing emergency coronary angiography was studied over a 1-year follow-up period.
  • Time-weighted cumulative SII and duration of high SII exposure were calculated from hospitalization to 1-year follow-up.
  • Patients were categorized based on time-weighted cumulative SII and SII slope to analyze MACE risk.

Main Results:

  • After adjusting for confounders, a higher time-weighted cumulative SII (above median) was associated with increased MACE risk (HR, 1.090).
  • Patients with high time-weighted cumulative SII and a positive SII slope demonstrated a significantly higher risk of MACE (HR, 4.096).
  • Late elevations in SII, even with similar cumulative exposure, were linked to a greater MACE risk.

Conclusions:

  • Long-term cumulative exposure to SII is a significant predictor of MACE in STEMI patients post-PCI.
  • The timing and persistence of elevated SII levels, particularly late increases, are critical determinants of adverse cardiovascular events.
  • Effective late-phase inflammation control is crucial for improving long-term prognosis in STEMI patients.

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