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The prognostic values of the SII and the SIRI in patients with STEMI following percutaneous coronary intervention: a
Haoyu Yan1,2, Yan Ye1, Senlin Hu1,2
1Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
Insights
Systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) predict mortality and major adverse cardiovascular events (MACEs) in ST-segment elevation myocardial infarction (STEMI) patients post-percutaneous coronary intervention (PCI). Higher SII and SIRI levels indicate increased risk.
Area of Science:
- Cardiovascular Medicine
- Inflammation Biomarkers
- Interventional Cardiology
Background:
- Systemic Immune-Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI) are emerging inflammatory markers.
- Their predictive value in ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI) is not well-established.
Purpose of the Study:
- To investigate and validate the association between SII, SIRI, and risks of all-cause mortality and major adverse cardiovascular events (MACEs).
- To assess the predictive capabilities of SII and SIRI in STEMI patients post-PCI.
Main Methods:
- 1222 STEMI patients undergoing urgent PCI were analyzed.
- Cox proportional hazards regression and Receiver Operating Characteristic (ROC) curves were used to evaluate associations and predictive values.
- Restricted cubic spline (RCS) curves explored non-linear relationships.
Main Results:
- Higher log10 SII and SIRI levels were independent risk factors for both all-cause mortality and MACEs after 1-year follow-up.
- Log10 SII and SIRI demonstrated predictive value for mortality and MACEs, with combined AUCs of 0.781 and 0.694, respectively.
- RCS curves revealed non-linear relationships between SIRI and outcomes, but not log10 SII.
Conclusions:
- Log10 SII and SIRI are positively associated with increased risks of all-cause mortality and MACEs in STEMI patients post-PCI.
- The predictive significance is more pronounced at higher levels of these inflammatory indices.
Background:
Although systemic immune-inflammation index (SII) and the systemic inflammation response index (SIRI) have garnered attention as novel inflammatory response markers in various clinical contexts, their application in patients with ST-segment elevation myocardial infarction (STEMI) following percutaneous coronary intervention (PCI) remains unclear. This study aims to fill this gap by investigating and validating the relationships between SII, SIRI, and the risks for all-cause mortality and major adverse cardiovascular events (MACEs) in this specific patient population.
Methods:
1222 participants diagnosed with STEMI and who underwent urgent PCI were included in the study. Cox proportional hazards regression analyses were employed to analyze the association between log10 SII, SIRI, and the occurrence of all-cause mortality and MACEs. Receiver operating characteristic (ROC) curves were used to compare the predictive values of log10 SII and SIRI for all-cause mortality and MACEs. Restricted cubic spline (RCS) curves were performed to explore the non-linear relationships between log10 SII, SIRI and all-cause mortality, MACEs. Additionally, subgroup analyses were conducted to further investigate the distribution characteristics of log10 SII and SIRI across different participant groups.
Results:
After a 1-year follow-up, 106 experienced all-cause mortality, and 163 experienced MACEs. Higher levels of log10 SII and SIRI were independent risk factors for all-cause mortality (log10 SII: hazard ratio [HR] = 8.994, 95% confidence interval [CI] 1.265-63.948, p = 0.028; SIRI: HR = 3.671, 95% CI 1.004-13.425, p = 0.049) after adjusting for covariates. The area under the curve (AUC) for log10 SII and SIRI combined with other variables was 0.781. Meanwhile, higher levels of log10 SII and SIRI were also independent risk factors for MACEs (log10 SII: HR = 6.465, 95% CI 1.356-30.821, p = 0.019; SIRI: HR = 4.739, 95% CI 1.778-12.632, p = 0.002) after adjusting for covariates. The AUC for log10 SII and SIRI combined with other variables was 0.694. The restricted cubic spline (RCS) curves indicated non-linear relationships between SIRI not log10 SII and all-cause mortality, MACEs.
Conclusions:
Log10 SII and SIRI are positively associated with the occurrence of all-cause mortality and MACEs, with this correlation being more significant in the higher-level log10 SII and SIRI groups.
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