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Systemic inflammatory response index: a novel predictor for cardiovascular disease risk in patients with primary
1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Beijing, 100029, China.
Insights
Systemic inflammatory response index (SIRI) is a promising biomarker for cardiovascular disease (CVD) in primary biliary cholangitis (PBC) patients. Higher SIRI levels independently predict increased CVD risk, aiding clinical risk stratification.
Area of Science:
- Hepatology
- Cardiology
- Immunology
Background:
- Cardiovascular disease (CVD) poses a significant risk for patients with primary biliary cholangitis (PBC).
- Immune dysregulation and chronic inflammation in PBC contribute to elevated CVD risk.
- Traditional CVD biomarkers may lack predictive accuracy in the PBC population.
Purpose of the Study:
- To investigate the association between inflammatory biomarkers and CVD in patients diagnosed with PBC.
- To evaluate the predictive value of inflammatory biomarkers for CVD in this specific patient cohort.
Main Methods:
- Retrospective analysis of PBC patients treated at Beijing Ditan Hospital (2018-2022).
- Multivariate logistic regression models assessed the relationship between SIRI, SII, NLR, MLR, and CVD.
- Receiver operating characteristic (ROC) curves evaluated predictive performance; restricted cubic spline (RCS) analysis explored SIRI-CVD relationship.
Main Results:
- CVD prevalence was 16.9% among PBC patients.
- Systemic inflammatory response index (SIRI) was identified as an independent risk factor for CVD.
- Each SD increase in SIRI correlated with a 79.2% increased CVD risk (OR=1.792).
- SIRI demonstrated superior predictive ability (AUC=0.725) compared to NLR, MLR, and SII.
- A linear association between SIRI and CVD was observed, with increased risk for SIRI > 0.65.
Conclusions:
- SIRI is a valuable inflammatory biomarker for predicting CVD in PBC patients.
- The association between SIRI and CVD risk remains robust across various subgroups, except for older age and cirrhosis.
- Incorporating SIRI into clinical practice can enhance CVD risk stratification and guide preventive strategies for PBC patients.
Objective:
Cardiovascular disease (CVD) is a significant concern in patients with primary biliary cholangitis (PBC) due to the combined effects of immune dysregulation and chronic inflammation. Traditional biomarkers may have limited predictive value for CVD in this population. This study aims to investigate the relationship between inflammatory biomarkers and CVD in patients with PBC.
Methods:
Patients with PBC who were treated at Beijing Ditan Hospital between January 2018 and December 2022 were included. Multivariate logistic regression models were performed to investigate the association between systemic inflammatory response index (SIRI), systemic immune inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), and monocyte-to-lymphocyte ratio (MLR) and CVD. The predictive value of inflammatory biomarkers for CVD was evaluated using receiver operating characteristic (ROC) curves. In addition, a restricted cubic spline (RCS) fitted with a logistic regression model was used to analyze the relationship between SIRI and CVD.
Results:
The prevalence of CVD in patients with PBC was 16.9% (n = 71). Multivariate logistic regression analysis showed that SIRI was an independent risk factor for CVD prevalence. Each standard deviation increase in SIRI was associated with a 79.2% increased risk of CVD (OR = 1.792, 95%CI = 1.348-2.382, P < 0.001). SIRI demonstrated moderate predictive ability for CVD, with an area under the curve (AUC) of 0.725. However, it was superior to NLR (AUC = 0.626), MLR (AUC = 0.579) and SII (AUC = 0.599). Subgroup analysis showed that the association between SIRI and CVD risk was robust with respect to gender, body mass index, smoking, drinking, hypertension, and diabetes mellitus, except for older age and cirrhosis status. The RCS analysis showed a stable linear relationship between SIRI and CVD, with significantly increased odds of CVD for SIRI values > 0.65.
Conclusion:
SIRI is a promising inflammatory biomarker and is independently associated with CVD prevalence in patients with PBC. Clinicians may consider incorporating SIRI into clinical practice to better stratify CVD risk and guide preventive strategies in this vulnerable population.
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