The Systemic Immune Inflammatory Response Index Can Predict the Clinical Prognosis of Patients with Initially Diagnosed Coronary Artery Disease

Abstract

Background

Recently, the systemic immune inflammatory response index (SIIRI), a novel and expanded inflammatory response marker, has been an independent predictor of lesion severity in patients with acute coronary syndrome (ACS). However, its predictive role in patients with initially diagnosed coronary artery disease (CAD) remains to be explored.

Patients and Methods

We evaluated 959 patients with CAD undergoing an initial coronary intervention. Each patient had laboratory measurements, including blood cell counts, taken after admission and before interventional treatment. The primary endpoint was major cardiovascular events (MACEs), defined as cardiovascular death, nonfatal myocardial infarction(MI), and nonfatal stroke. The secondary endpoints included MACEs and readmission for congestive heart failure(HF).

Results

During a mean follow-up period of 33.3±9.9 months, 229 (23.9%) MACEs were recorded. ROC curve analysis displayed that the best cut-off value of SIIRI for predicting MACEs was 247.17*10¹⁸/L². Kaplan-Meier survival curve analysis showed that the survival rate of the low SIIRI group was higher than that of the high SIIRI group (P<0.001). Compared with the low SIIRI group, the high SIIRI group had a significantly higher risk of MACEs (187 cases (39.53%) vs.42 patients (8.64%), P<0.001). Univariate and multivariate Cox regression analyses displayed that high SIIRI levels were independently associated with the occurrence of MACEs in patients with initially diagnosed CAD undergoing percutaneous coronary intervention (PCI) (adjusted hazard ratio [HR]: 3.808, 95% confidence interval [CI%]: 2.643–5.486, P<0.001). Adding SIIRI to conventional risk factor models improved the predictive value of MACEs.

Conclusion

Elevated SIIRI is associated with adverse cardiovascular prognosis in patients with initially diagnosed CAD. SIIRI can be a simple and practical index to identify high-risk patients with CAD after PCI.

Keywords:

• systemic immune inflammatory response index
• coronary artery disease
• inflammation
• markers
• blood cell count

Ethics Statement

The study complied with the Declaration of Helsinki and was permitted by the Second Affiliated Hospital of Tianjin Medical University (IRB number 2023-05-B023). Patients/participants all signed informed consent before enrollment. Permission was obtained from the patient/participant at each follow-up visit.

Acknowledgments

We gratefully acknowledge the assistance of the investigators of the Second Hospital of Tianjin Medical University and the participant’s support.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China (No. 82100342) and the Tianjin Key Medical Discipline (Specialty) Construction Project (TJYXZDXK-029A).