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Elevated inflammatory index and future risk of stroke in patients with coronary heart disease: a multicenter
Jie Cheng1, Keli Li2, Meng Chen3
1Department of Cardiology II and Geriatric Management Ward, Zhangye Second People's Hospital, Zhangye, China.
Insights
Inflammation increases stroke risk in coronary heart disease (CHD) patients. The aggregate index of systemic inflammation (AISI) best predicts this risk, aiding early monitoring.
Area of Science:
- Cardiology
- Inflammation Research
- Stroke Prevention
Background:
- Coronary heart disease (CHD) patients have a higher stroke risk.
- Inflammation is a key factor contributing to this elevated risk.
- Emerging inflammatory markers require investigation for stroke risk prediction in CHD.
Purpose of the Study:
- To investigate associations between three inflammatory markers and stroke risk in CHD patients.
- To identify the most clinically valuable inflammatory marker for stroke risk prediction.
- To explore potential dose-response relationships between markers and stroke risk.
Main Methods:
- COX regression analysis of 5,289 CHD patients.
- Evaluation of systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), and aggregate index of systemic inflammation (AISI).
- Kaplan-Meier curves, restricted cubic splines, and ROC analysis for risk and predictive performance assessment.
Main Results:
- All three inflammatory markers (SIRI, SII, AISI) significantly correlated with increased stroke risk.
- Higher inflammation levels corresponded to higher stroke incidence.
- AISI demonstrated superior predictive performance compared to SII and SIRI.
Conclusions:
- SIRI, SII, and AISI are linked to increased stroke risk in CHD.
- AISI offers superior predictive value for stroke risk in CHD patients.
- AISI may serve as a tool for early stroke risk monitoring and assessment in CHD.
Background:
Previous studies have consistently shown that patients with coronary heart disease (CHD) face an elevated risk of stroke, with inflammation likely playing a significant contributing role. Building on this evidence, the present study aims to investigate the associations between three emerging inflammatory markers and the risk of stroke in patients with CHD, as well as to identify which marker offers the greatest clinical predictive value.
Methods:
This study involved 5,289 patients with CHD from three clinical centers. COX regression analysis was conducted to examine the relationships between three inflammatory markers-systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), and aggregate index of systemic inflammation (AISI)-and the risk of stroke in patients with CHD, and Kaplan-Meier (KM) curves were generated to visualize stroke incidence across different marker levels. In addition, restricted cubic splines (RCS) were applied to assess potential dose-response relationships. Finally, receiver operating characteristic curves and C-statistics were used to evaluate the predictive performance of the three inflammatory markers for stroke risk.
Results:
During the 4.82-year median follow-up period, a total of 785 participants experienced stroke events. The COX regression analysis showed that all three inflammatory markers were significantly associated with an increased risk of stroke in patients with CHD. Consistently, the KM curves indicated that patients with higher levels of inflammation experienced a markedly higher incidence of stroke compared with those in the low-inflammation group. Furthermore, the RCS analysis revealed that when AISI, SII, and SIRI exceeded 117, 450, and 0.95, respectively, the risk of stroke rose substantially. Finally, the comparative analysis showed that AISI demonstrates significantly better predictive performance.
Conclusion:
These three inflammatory indicators are closely linked to an increased risk of stroke in patients with CHD. In addition, comparative analysis indicates that the inflammatory index represented by AISI has superior predictive performance. Consequently, AISI may offer a feasible tool for early monitoring and risk assessment of stroke in patients with CHD.
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