Prognostic value of the Scottish inflammatory prognostic score in ST-Segment elevation myocardial infarction

The Scottish Inflammatory Prognostic Score (SIPS), has emerged as a simple inflammation-based biomarker; however, its prognostic value in ST-segment elevation myocardial infarction (STEMI) has not been well established. This study aimed to evaluate the prognostic utility of SIPS for predicting long-term major adverse cardiac events (MACE) in STEMI patients.

We included 829 STEMI patients between 2018 and 2024. SIPS was categorized as low (0 points), moderate (1 point), or high risk (2 points). The primary endpoint was time-to-first MACE, defined as a composite of all-cause mortality, non-fatal myocardial infarction, stroke, or cardiovascular hospitalization, using Cox proportional hazards models, competing risk analysis, and measures of incremental discrimination.

During follow-up, MACE occurred in 293 patients (35.3%), with a stepwise increase across SIPS categories (23%, 40%, and 63%; p < 0.001). SIPS independently predicted MACE in multivariable analysis (HR per point: 1.62, 95% CI 1.35-1.94; p < 0.001). Discriminative performance was moderate (AUC = 0.655). SIPS remained independently associated with MACE in hierarchical multivariable and competing risk analyses and provided incremental prognostic value beyond clinical predictors.

SIPS is an independent predictor of long-term MACE in STEMI patients after PPCI and may serve as a simple and cost-effective tool for early risk stratification.